Provider Demographics
NPI:1952428203
Name:WARREN, KRISTEN HORNER (LAC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:HORNER
Last Name:WARREN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 OLD HEWITT RD STE D
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3548
Mailing Address - Country:US
Mailing Address - Phone:254-741-6030
Mailing Address - Fax:
Practice Address - Street 1:201 OLD HEWITT RD STE D
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3548
Practice Address - Country:US
Practice Address - Phone:254-741-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00703171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740610666OtherNPPES