Provider Demographics
NPI:1245703099
Name:WARRINGTON, LISA RENEE (APRN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:WARRINGTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5829 W VILLAS CT
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-2016
Mailing Address - Country:US
Mailing Address - Phone:405-269-1207
Mailing Address - Fax:
Practice Address - Street 1:12 E MACARTHUR ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-2135
Practice Address - Country:US
Practice Address - Phone:405-275-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR73703363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily