Healthcare Provider Details

I. General information

NPI: 1770413874
Provider Name (Legal Business Name): KATHERINE ANN WARRICK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 JOHN H WITHERINGTON DR
TROY AL
36081-4878
US

IV. Provider business mailing address

126 CLINIC DR
DOTHAN AL
36303-1980
US

V. Phone/Fax

Practice location:
  • Phone: 334-697-3007
  • Fax: 334-697-3022
Mailing address:
  • Phone: 334-793-1811
  • Fax: 334-712-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-193617
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: