Warren, Stephanie Lise

Warren, Stephanie Lise is an individual health care provider with primary practice located at 4000 Kresge Way , Louisville KY 40207. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Warren, Stephanie Lise can be contacted via phone (502) 896-7660.

Contact Information

Primary practice address
4000 Kresge Way Louisville KY 40207
Phone: (502) 896-7660
Fax: (502) 896-7661
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 55730 Tennessee
Allopathic & Osteopathic Physicians / Surgery 208600000X 51506 Kentucky

Profile Details

NPI number 1962778779
LBN Legal business name Warren, Stephanie Lise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2012
Last updated Dec 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962778779 NPPES
Kentucky MEDICAID 7100260670

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