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NPI Code Detail

MEDICARE: SUSAN J WARNER-OBERWORTMANN APN

MEDICARE: SUSAN J WARNER-OBERWORTMANN APN
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
1363L00000XNurse PractitionerAPN 06621TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528164688
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN J WARNER-OBERWORTMANN APN
Provider Business Mailing Address
First Line : 100 WILLIAM NORTHERN BLVD
Second Line :
City : TULLAHOMA
State : TN
Zip : 37388-4754
Country : US
Telephone Number : 931-454-0489
Fax Number : 931-454-2348
Provider Business Practice Location Address
First Line : 100 WILLIAM NORTHERN BLVD
Second Line :
City : TULLAHOMA
State : TN
Zip : 37388-4754
Country : US
Telephone Number : 931-454-0489
Fax Number : 931-454-2348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 03/20/2013

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