Individual
MS. LISA K WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2901 W 101ST ST N, VALLEY CENTER, KS 67147
(316) 650-9837
Mailing address
1827 FARMSTEAD ST, WICHITA, KS 67208-1745
(316) 650-9837
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1500813
KS
363AM0700X
Medical Physician Assistant
Primary
1500813
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100422140F
—
KS
05
—
100422140I
—
KS
Enumeration date
05/03/2006
Last updated
03/13/2020
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