Individual
MARY KATHLEEN WARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(219) 241-3928
Mailing address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(219) 241-3928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/07/2025
Last updated
09/08/2025
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