Provider Demographics
NPI:1942194642
Name:WARREN, EMMANUEL (CNA)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:WARREN
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17521 KIBLER RD
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-7641
Mailing Address - Country:US
Mailing Address - Phone:540-935-0946
Mailing Address - Fax:
Practice Address - Street 1:17521 KIBLER RD
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-7641
Practice Address - Country:US
Practice Address - Phone:540-935-0946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA376K00000X
172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No376K00000XNursing Service Related ProvidersNurse's Aide