Healthcare Provider Details

I. General information

NPI: 1023723079
Provider Name (Legal Business Name): ABOVE DIABETES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 10/25/2025
Certification Date: 10/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8970 COUNTY ROAD 512
ANNA TX
75409-8006
US

IV. Provider business mailing address

546 FAIR DR
ROCKWALL TX
75087-6797
US

V. Phone/Fax

Practice location:
  • Phone: 435-339-0220
  • Fax: 435-339-0220
Mailing address:
  • Phone: 801-920-1453
  • Fax: 801-702-8143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ARIEL WARREN
Title or Position: OWNER
Credential: RDN, CD, CDCES
Phone: 801-920-1453