Provider Demographics
NPI:1649387481
Name:WARREN, NANCY H (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:H
Last Name:WARREN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-212-5025
Mailing Address - Fax:859-212-4432
Practice Address - Street 1:7370 TURFWAY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4895
Practice Address - Country:US
Practice Address - Phone:859-212-5025
Practice Address - Fax:859-212-4432
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002910363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0052974Medicaid
KY78003860Medicaid
IN201004110Medicaid
IN201004110Medicaid