Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | APN0000007698 | TN |
NPI | 1083831028 |
---|---|
Provider Name | Mrs. Deborah Colleen Warren |
First Address | Scottsboro, AL 35768-5439 |
Second Address | Chattanooga, TN 37411-5616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |