Provider Demographics
NPI:1295329217
Name:WARREN, DEMETRIA D (NCMA)
Entity type:Individual
Prefix:
First Name:DEMETRIA
Middle Name:D
Last Name:WARREN
Suffix:
Gender:F
Credentials:NCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 53RD ST E APT 333
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-5894
Mailing Address - Country:US
Mailing Address - Phone:941-799-0148
Mailing Address - Fax:
Practice Address - Street 1:955 53RD ST E APT 333
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-5894
Practice Address - Country:US
Practice Address - Phone:941-799-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion