Individual
TYISHA TAMEKA WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6330 NEWTOWN RD STE 630, NORFOLK, VA 23502-4802
(757) 266-2834
Mailing address
6330 NEWTOWN RD STE 630, NORFOLK, VA 23502-4802
(757) 266-2834
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49D2248193
CLIA
VA
Enumeration date
01/12/2022
Last updated
01/12/2022
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