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General NPI Number Information
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NPI Number | 1477569473
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Entity Type | Individual
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Provider Name | MARILYN R WARREN RN, CNS, RXS
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 28374 COUNTY ROAD 317
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City | BUENA VISTA
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State | CO
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Zip | 81211-9158
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Country | US
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Telephone | 719-538-6502
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Fax | 719-539-3988
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Provider Business Mailing Address
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Address Line | 28374 COUNTY ROAD 317
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City | BUENA VISTA
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State | CO
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Zip | 81211-9158
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Country | US
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Telephone | 719-539-6502
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Fax | 719-539-3988
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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 | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN29972
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN29972
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | CNS-3854
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License Number State | CO
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