Individual
STEPHANIE LISE WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207
(502) 896-7660
(502) 896-7661
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 489-6613
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
51506
KY
208600000X
Surgery Physician
55730
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100260670
—
KY
Enumeration date
03/26/2012
Last updated
12/10/2020
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