Healthcare Provider Details

I. General information

NPI: 1043565229
Provider Name (Legal Business Name): SUSAN S WARRINER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 AMHERST ST STE 310
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

1880 AMHERST ST STE 2B
WINCHESTER VA
22601-2808
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-6721
  • Fax: 540-536-6724
Mailing address:
  • Phone: 540-536-6721
  • Fax: 540-536-6724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024170164
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: