Active NPI
Angela Warren
- Nurse Practitioner
- Middlesboro, KY
National Provider Identifier
1295874980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3461P
- Practice address
- 111 N 21St St
Middlesboro, KY 40965-1375 - Phone
- (606) 248-2862
- Fax
- (606) 248-2876
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3461P | KY | Primary |
Addresses
Primary practice location
111 N 21St St
Middlesboro, KY 40965-1375
Mailing address
PO Box 158
Manchester Square Shopping Ctr. Room 212
Manchester, KY 40962-0158
Phone (606) 598-5564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3461P | KY | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295874980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"address_2": "MANCHESTER SQUARE SHOPPING CTR. ROOM 212",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409620158",
"telephone_number": "606-598-5564",
"fax_number": "606-598-6615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N 21ST ST",
"city": "MIDDLESBORO",
"state": "KY",
"postal_code": "409651375",
"telephone_number": "606-248-2862",
"fax_number": "606-248-2876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "ANGELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3461P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middlesboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.