Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 330061 | NY |
NPI | 1003807793 |
---|---|
Provider Name | Ms. Karen Warner |
First Address | New Hartford, NY 13413-1001 |
Second Address | New Hartford, NY 13413-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02329046 | (05) | NY |
S98055 | (02) |