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General NPI Number Information
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NPI Number | 1013909324
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Entity Type | Individual
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Provider Name | KENNETH P WARREN APRN
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 2202 E 49TH ST STE 600
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City | TULSA
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State | OK
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Zip | 74105-8716
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Country | US
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Telephone | 918-591-3567
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Fax | 918-591-3568
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Provider Business Mailing Address
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Address Line | 2202 E 49TH ST STE 600
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City | TULSA
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State | OK
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Zip | 74105-8716
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Country | US
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Telephone | 918-591-3567
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Fax | 918-591-3568
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R0050761
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License Number State | OK
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