MEDICARE: MS. CHEZNA W WARNER PA-C

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	363A00000X	Physician Assistant	15 00823	KS

General Provider Information

NPI Number	:	1457323271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHEZNA W WARNER PA-C

Provider Business Mailing Address
First Line	:	120 TREVILLIAN AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-4829
Country	:	US
Telephone Number	:	314-471-5808
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 DOUGHERTY FERRY RD
Second Line	:	SUITE 205
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-3383
Country	:	US
Telephone Number	:	314-977-4440
Fax Number	:

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	06/28/2012

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