Provider Demographics
NPI:1790360907
Name:WARREN, INDIA (PA-C)
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:INDIA
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1621 HIGHWAY E29
Mailing Address - Street 2:
Mailing Address - City:GARWIN
Mailing Address - State:IA
Mailing Address - Zip Code:50632-9571
Mailing Address - Country:US
Mailing Address - Phone:515-238-2822
Mailing Address - Fax:
Practice Address - Street 1:303 NICHOLAS DR
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4443
Practice Address - Country:US
Practice Address - Phone:641-753-2752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA116579363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant