Provider Demographics
NPI:1134391626
Name:WARMAN, ELIZABETH ANN (PC-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:WARMAN
Suffix:
Gender:F
Credentials:PC-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:DOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELLINWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:67526-1440
Mailing Address - Country:US
Mailing Address - Phone:620-564-3771
Mailing Address - Fax:
Practice Address - Street 1:611 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLINWOOD
Practice Address - State:KS
Practice Address - Zip Code:67526-1440
Practice Address - Country:US
Practice Address - Phone:620-564-3771
Practice Address - Fax:620-564-2684
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST01807363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical