DR. JAN E WARNER CP
Clinical Neuropsychologist
Mishawaka, Indiana
Provider NPI: 1043214679
Provider Information:DR. JAN E WARNER CP
Gender: M
Not Sole Proprietor
Practice Location:
230 E DAY RD #160 MISHAWAKA, IN 46545 US
Tel: 574-271-8222 Fax: 574-271-8896
Business Mailing Address:
230 E DAY RD #160 MISHAWAKA, IN 46545 US
Tel: 574-271-8222 Fax: 574-271-8896
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | IN | IN20040740 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
100383350A | IN | 05 | |
BLUE CROSS BLUE SHIELD | 000000196536 | IN | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin