Individual
RETA DIANE WARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Mailing address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201250138NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500666144
—
OR
Enumeration date
09/18/2012
Last updated
06/21/2022
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