# DR. SHERISA WARREN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700104015
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 5101018187 | MI | — |
| 208600000X | Surgery Physician | 7204 | OK | — |
| 208600000X | Surgery Physician | TP417 | KY | — |
| 2086S0129X | Vascular Surgery Physician | 7204 | OK | Yes |
| 2086S0129X | Vascular Surgery Physician | TP417 | KY | — |

## Other

- **Enumeration date:** 05/11/2010
- **Last updated:** 05/17/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 7204 | STATE LICENSE | OK |