Provider Demographics
NPI:1487081832
Name:WARNER FAMILY MEDICINE, PC
Entity type:Organization
Organization Name:WARNER FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-471-9005
Mailing Address - Street 1:188 INDUSTRIAL PARK RD STE B
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4125
Mailing Address - Country:US
Mailing Address - Phone:814-471-9005
Mailing Address - Fax:814-471-9007
Practice Address - Street 1:188 INDUSTRIAL PARK RD STE B
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4125
Practice Address - Country:US
Practice Address - Phone:814-471-9005
Practice Address - Fax:814-471-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013126363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty