Provider Demographics
NPI:1548526569
Name:WARNER, SHIRLEY ANNE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:ANNE
Last Name:WARNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-9737
Mailing Address - Country:US
Mailing Address - Phone:336-846-6100
Mailing Address - Fax:336-846-7900
Practice Address - Street 1:205 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694-9737
Practice Address - Country:US
Practice Address - Phone:336-846-6100
Practice Address - Fax:336-846-7900
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily