Healthcare Provider Details

I. General information

NPI: 1477070753
Provider Name (Legal Business Name): SHAYLA WARNKEN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 CENTENNIAL CIR
NORTH PLATTE NE
69101-6586
US

IV. Provider business mailing address

1310 E 6TH ST
NORTH PLATTE NE
69101-4327
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-7000
  • Fax:
Mailing address:
  • Phone: 308-708-1232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2098
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: