Provider Demographics
NPI:1659605442
Name:WARREN, KRISTEN RENEE (RN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RENEE
Last Name:WARREN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20502 GLADSTONE RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-751-0007
Mailing Address - Fax:
Practice Address - Street 1:20502 GLADSTONE RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6320
Practice Address - Country:US
Practice Address - Phone:216-751-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN318296163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical