Provider Demographics
NPI:1649585514
Name:WARREN, CAROLYN JANE
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JANE
Last Name:WARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BELLWOOD PL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2733
Mailing Address - Country:US
Mailing Address - Phone:859-685-0550
Mailing Address - Fax:
Practice Address - Street 1:201 BELLWOOD PL
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2733
Practice Address - Country:US
Practice Address - Phone:859-625-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator