Provider Demographics
NPI:1851342356
Name:WARNER, NANCY J (PA-C)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:J
Last Name:WARNER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2500 STARLING ST
Mailing Address - Street 2:SUITE 504
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4265
Mailing Address - Country:US
Mailing Address - Phone:912-466-5504
Mailing Address - Fax:912-466-5593
Practice Address - Street 1:2500 STARLING ST
Practice Address - Street 2:SUITE 504
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4265
Practice Address - Country:US
Practice Address - Phone:912-466-5504
Practice Address - Fax:912-466-5593
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-03-25
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Provider Licenses
StateLicense IDTaxonomies
GA002107363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAS26999Medicare UPIN
GAS26999Medicare UPIN