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1972554129

NPI Code Detail

MEDICARE: PHYLIS I WARKENTIN MD

MEDICARE: PHYLIS I WARKENTIN MD

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	207ZB0001X	Blood Banking & Transfusion Medicine Physician	17542	NE
2	2080P0207X	Pediatric Hematology & Oncology Physician	17542	NE

Other Identifiers

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

General Provider Information

NPI Number	:	1972554129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHYLIS I WARKENTIN MD

Provider Business Mailing Address
First Line	:	988102 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-8102
Country	:	US
Telephone Number	:	402-559-4186
Fax Number	:	402-559-6018

Provider Business Practice Location Address
First Line	:	988102 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-8102
Country	:	US
Telephone Number	:	402-559-4186
Fax Number	:	402-559-6018

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	06/24/2011

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Directions to “ PHYLIS I WARKENTIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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