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General NPI Number Information
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NPI Number | 1912092941
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Entity Type | Individual
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Provider Name | JORETTA WARREN NP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3420 SOUTH RANKIN
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City | EDMOND
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-941-1433
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 WILL ROGERS PKWY SUITE 600
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City | OKLAHOMA CITY
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State | OK
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Zip | 73108-1826
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Country | US
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Telephone | 405-943-1144
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Fax | 405-943-0127
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R0037176
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License Number State | OK
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