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General NPI Number Information
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NPI Number | 1144124660
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Entity Type | Individual
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Provider Name | AMY NICOLE SMITH WARREN LPN
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Gender | Female
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 1607 EXECUTIVE AVE
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-6501
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Country | US
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Telephone | 843-712-7316
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Fax | 843-954-1022
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Provider Business Mailing Address
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Address Line | 4600 MONTGOMERY RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45212-2600
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Country | US
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Telephone | 833-510-4357
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Fax | 866-460-2997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 0002075119
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 58416
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 60847
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License Number State | SC
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