Provider Demographics
NPI:1073253233
Name:WARDEN, KAREN LORENE (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LORENE
Last Name:WARDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36322 COUNTY ROAD 390
Mailing Address - Street 2:
Mailing Address - City:GOBLES
Mailing Address - State:MI
Mailing Address - Zip Code:49055-9072
Mailing Address - Country:US
Mailing Address - Phone:269-492-8106
Mailing Address - Fax:
Practice Address - Street 1:36322 COUNTY ROAD 390
Practice Address - Street 2:
Practice Address - City:GOBLES
Practice Address - State:MI
Practice Address - Zip Code:49055-9072
Practice Address - Country:US
Practice Address - Phone:269-492-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704213122363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner