Individual
MRS. WENDY M WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3999 DUTCHMANS LN STE 6F, LOUISVILLE, KY 40207-4724
(502) 394-5678
(502) 394-5600
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA557
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95003208
—
KY
Enumeration date
01/22/2007
Last updated
11/18/2024
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