Individual
MS. CODI LYN WARNECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4504 LAX LAKE RD, SILVER BAY, MN 55614-3806
(218) 220-8947
Mailing address
4504 LAX LAKE RD, SILVER BAY, MN 55614-3806
(218) 220-8947
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R179350-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
868K1CA
BLUE CROSS BLUE SHEILD
MN
Enumeration date
04/02/2010
Last updated
01/30/2023
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