Provider Demographics
NPI:1144306887
Name:WARREN, ANNE MARGARET (RN, MS, ANP-BC, ADCN)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARGARET
Last Name:WARREN
Suffix:
Gender:F
Credentials:RN, MS, ANP-BC, ADCN
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARGARET
Other - Last Name:STEPHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:31500 TELEGRAPH RD
Mailing Address - Street 2:SUITE 010
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4367
Mailing Address - Country:US
Mailing Address - Phone:248-552-0620
Mailing Address - Fax:
Practice Address - Street 1:47601 GRAND RIVER AVE
Practice Address - Street 2:SUITE 2 SOUTH
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1233
Practice Address - Country:US
Practice Address - Phone:248-552-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704150790363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4899560Medicaid