Individual
JESSICA WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-NP
Contact information
Practice address
3116 WILLETT DR, LARAMIE, WY 82072-5048
(307) 742-9411
(307) 742-9423
Mailing address
3116 WILLETT DR, LARAMIE, WY 82072-5048
(307) 742-9411
(307) 742-9423
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
40332.1643
WY
363LF0000X
Family Nurse Practitioner
111531
NE
363LF0000X
Family Nurse Practitioner
Primary
40332.1643
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114368131
—
WY
Enumeration date
07/08/2013
Last updated
09/14/2021
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