Individual
QUANTANIECE SHANTE WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1341 E 143RD ST # UP, EAST CLEVELAND, OH 44112-2539
(216) 322-3126
Mailing address
1341 E 143RD ST # UP, EAST CLEVELAND, OH 44112-2539
(216) 322-3126
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401385720512
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40385720512
STATE TESTED NURSING ASISSTANT
OH
Enumeration date
08/15/2012
Last updated
08/15/2012
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