Healthcare Provider Details

I. General information

NPI: 1326382722
Provider Name (Legal Business Name): KATHERINE L WARNER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 AVONDALE AVE
HORNELL NY
14843-1002
US

IV. Provider business mailing address

2 AVONDALE AVE
HORNELL NY
14843-1002
US

V. Phone/Fax

Practice location:
  • Phone: 607-324-0014
  • Fax: 607-324-7478
Mailing address:
  • Phone: 607-324-0014
  • Fax: 607-324-7478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number22605049
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: