Individual
LINDA ELAINE WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
813 W MICHIGAN AVE, JACKSON, MI 49202-4158
(517) 796-6430
(517) 784-6984
Mailing address
DEPARTMENT 272801, PO BOX 67000, DETROIT, MI 48267-2728
(517) 841-6913
(517) 841-6917
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704137000
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4600781
—
MI
01
—
C810570
BCBSM GROUP
MI
01
—
P00146040
RR MEDICARE
MI
Enumeration date
05/12/2006
Last updated
11/27/2007
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