Individual
KERRY J WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 678-3116
Mailing address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37000056A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430420
MEDICARE PTAN
IN
01
—
Q00592862
RAILROAD PTAN
IN
Enumeration date
03/17/2016
Last updated
04/18/2024
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