Individual
SUE B WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
485 ARSENAL ST, WATERTOWN, MA 02472-5091
(617) 972-5100
Mailing address
485 ARSENAL ST, WATERTOWN, MA 02472-5091
(617) 972-5100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
157937
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
157937
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP9897
BLUE CROSS
MA
05
—
P36499
—
MA
01
—
PF856
HARVARD PILGRIM
MA
Enumeration date
03/08/2006
Last updated
03/08/2021
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