Provider Demographics
NPI:1528609096
Name:WARNER, BRITTANY (OD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 E ORION ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3235
Mailing Address - Country:US
Mailing Address - Phone:623-500-9734
Mailing Address - Fax:
Practice Address - Street 1:3271 E QUEEN CREEK RD STE 107
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8511
Practice Address - Country:US
Practice Address - Phone:480-892-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34417152W00000X
AZOPT-002486152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty