Provider Demographics
NPI:1487255410
Name:WARNE, ADRIANA CRYSTAL (RN)
Entity type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:CRYSTAL
Last Name:WARNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 E FLOSSMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2533
Mailing Address - Country:US
Mailing Address - Phone:815-975-1049
Mailing Address - Fax:
Practice Address - Street 1:3849 E FLOSSMOOR AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2533
Practice Address - Country:US
Practice Address - Phone:815-975-1049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ255036363LF0000X
AZRN183717163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse