MEDICARE: ELISABETH WARNER PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP8328	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95005444	CA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN215569	MA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1437	AK
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NUR-APRN-LIC-100000	MT
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	5917	CT
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CP000955	SD
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	884003	TX
9	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CNP131124	ME
10	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	063101-23	NH
11	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9461344-4405	UT

General Provider Information

NPI Number	:	1457656886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETH WARNER PMHNP-BC

Provider Business Mailing Address
First Line	:	774 E 2100 S STE 424
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-1863
Country	:	US
Telephone Number	:	801-251-6736
Fax Number	:

Provider Business Practice Location Address
First Line	:	774 E 2100 S STE 424
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-1863
Country	:	US
Telephone Number	:	801-251-6736
Fax Number	:	949-703-7340

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

Provider Enumeration Date	:	01/15/2011
Last Update Date	:	08/31/2024

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