Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | COA.13128-NP | OH |
NPI | 1437422243 |
---|---|
Provider Name | Kara Elizabeth Warren |
First Address | Dayton, OH 45414-2855 |
Second Address | Dayton, OH 45409-1328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2012 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0092776 | (05) | OH |