Individual
MRS. CARLY DION WAREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1027 E CHERRY ST, CUSHING, OK 74023-4101
(918) 225-8378
(918) 225-1291
Mailing address
PO BOX 720006, NORMAN, OK 73070-4006
(405) 533-6057
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
79453
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200097040A
—
OK
01
—
R0079453
LICENSE
OK
Enumeration date
02/17/2011
Last updated
05/15/2019
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