Basic Information
Provider Information
NPI: 1598242844
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARREN-BARNETT
FirstName: KATY
MiddleName: D'LYNN
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2210 DUNCAN REGIONAL LOOP
Address2:  
City: DUNCAN
State: OK
PostalCode: 735331564
CountryCode: US
TelephoneNumber: 5802516655
FaxNumber: 5802516668
Practice Location
Address1: INTERSECTION OF HWY 70 & HWY 81
Address2:  
City: WAURIKA
State: OK
PostalCode: 73573
CountryCode: US
TelephoneNumber: 5802283669
FaxNumber: 5804442628
Other Information
ProviderEnumerationDate: 07/19/2018
LastUpdateDate: 07/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X128740OKY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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