Healthcare Provider Details

I. General information

NPI: 1811223167
Provider Name (Legal Business Name): JENNIFER LINVILLE WARREN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N ELM ST PO BOX HP 5
HIGH POINT NC
27262-4331
US

IV. Provider business mailing address

517 BEECH RIDGE RD
THOMASVILLE NC
27360-9710
US

V. Phone/Fax

Practice location:
  • Phone: 336-878-6471
  • Fax: 336-878-6748
Mailing address:
  • Phone: 336-475-2563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0909216
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: