Individual
ANGELA D WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(731) 412-2103
Mailing address
PO BOX 1459, MINNEAPOLIS, MN 55440-1459
(731) 415-9290
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15684
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523639
—
TN
01
—
3380640
MEDICAID GROUP
TN
Enumeration date
03/03/2011
Last updated
07/09/2020
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