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General NPI Number Information
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NPI Number | 1245703099
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Entity Type | Individual
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Provider Name | LISA RENEE WARRINGTON APRN
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Gender | Female
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 12 E MACARTHUR ST
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City | SHAWNEE
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State | OK
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Zip | 74804-2135
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Country | US
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Telephone | 405-275-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 5829 W VILLAS CT
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City | STILLWATER
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State | OK
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Zip | 74074-2016
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Country | US
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Telephone | 405-269-1207
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R73703
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License Number State | OK
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