Individual
KENNETH H WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4290 COPPER RIDGE DR STE 200, TRAVERSE CITY, MI 49684-7205
(231) 935-8930
(231) 935-8811
Mailing address
4290 COPPER RIDGE DR STE 200, TRAVERSE CITY, MI 49684-7205
(231) 935-8930
(231) 935-8811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004373
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1152915100
BCBS
MI
01
—
5601004373
LICENSE
MI
Enumeration date
07/14/2006
Last updated
05/21/2026
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