Provider Demographics
NPI:1669433371
Name:WARREN, CATHERINE S (PA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:S
Last Name:WARREN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NASH ST N STE B
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1394
Mailing Address - Country:US
Mailing Address - Phone:252-237-1225
Mailing Address - Fax:252-640-2752
Practice Address - Street 1:2500 NASH ST N STE B
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1394
Practice Address - Country:US
Practice Address - Phone:252-237-2700
Practice Address - Fax:252-237-5034
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103234363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ26170Medicare UPIN
NC2761752Medicare ID - Type Unspecified