Provider Demographics
NPI:1982880266
Name:WARREN, TINA IRENE (RN)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:IRENE
Last Name:WARREN
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 1:3628 HOMEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1008
Mailing Address - Country:US
Mailing Address - Phone:419-708-0598
Mailing Address - Fax:
Practice Address - Street 1:3628 HOMEWOOD AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1008
Practice Address - Country:US
Practice Address - Phone:419-708-0598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-273314163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health