Individual
SHANNON WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2207 W VERNON CT, PEORIA, IL 61604-2355
(309) 453-8754
Mailing address
2207 W VERNON CT, PEORIA, IL 61604-2355
(309) 453-8754
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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