MEDICARE: SHARON RAE WARREN R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	086000196RN	OR

General Provider Information

NPI Number	:	1265866156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON RAE WARREN R.N.

Provider Business Mailing Address
First Line	:	555 FREEMAN RD
Second Line	:	SP 135
City	:	CENTRAL POINT
State	:	OR
Zip	:	97502-2567
Country	:	US
Telephone Number	:	541-840-9043
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 FREEMAN RD
Second Line	:	SP 135
City	:	CENTRAL POINT
State	:	OR
Zip	:	97502-2567
Country	:	US
Telephone Number	:	541-840-9043
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	12/02/2013

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