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Individual

JEANETTE RENEE WARREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
115 S INDEPENDENCE AVE, CUSHING, OK 74023-4154
(580) 706-0927
Mailing address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 216-4999
(918) 216-4998

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0037517
OK

Other

Enumeration date
08/17/2023
Last updated
08/17/2023
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