Individual
JORDAN W WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
137 LANCASTER ST, CRAB ORCHARD, KY 40419-9628
(270) 858-6655
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4607
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
015970
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100829030
—
KY
Enumeration date
07/05/2022
Last updated
07/03/2023
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