Provider Demographics
NPI:1144613860
Name:WARREN, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WARREN
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 1:285 GERMAN OAK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4487
Mailing Address - Country:US
Mailing Address - Phone:901-730-1336
Mailing Address - Fax:901-730-1376
Practice Address - Street 1:285 GERMAN OAK DR STE 101
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4487
Practice Address - Country:US
Practice Address - Phone:901-730-1336
Practice Address - Fax:901-730-1376
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000037596253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care