Provider Demographics
NPI:1184442113
Name:WARNOCK, KARA JEAN CUEVAS (CHW)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:JEAN CUEVAS
Last Name:WARNOCK
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-2816
Mailing Address - Country:US
Mailing Address - Phone:541-619-4525
Mailing Address - Fax:
Practice Address - Street 1:156 S 2ND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2816
Practice Address - Country:US
Practice Address - Phone:541-619-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTHW000003324172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker