# MARINA SHORES OB/GYN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417492034
- **Authorized official:** DR. LANI MARIE WARREN MD (OB/GYN PHYSICIAN)
- **Authorized official phone:** (757) 496-5000

## Contact information

- **Practice address:** 2865 LYNNHAVEN DR, SUITE 4A, VIRGINIA BEACH, VA 23451-1542
- **Practice address phone:** (757) 496-5000
- **Mailing address:** 2865 LYNNHAVEN DR, SUITE 4A, VIRGINIA BEACH, VA 23451-1542
- **Mailing address phone:** (757) 496-5000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 0101256943 | VA | Yes |
| 363L00000X | Nurse Practitioner | 0101256943 | VA | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | 0101256943 | VA | — |

## Other

- **Enumeration date:** 01/05/2017
- **Last updated:** 03/24/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1417492034 | GROUP- NPI | VA |