Provider Demographics
NPI:1902239239
Name:WARNER, JANELL RENEE
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:RENEE
Last Name:WARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12450 CLEVELAND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12450 CLEVELAND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8353
Practice Address - Country:US
Practice Address - Phone:919-771-0775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP144472251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics