Provider Demographics
NPI:1447843032
Name:WARREN, JENNIFER KRISTINE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KRISTINE
Last Name:WARREN
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KRISTINE
Other - Last Name:CHURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8591 CROSSROADS DRIVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514
Mailing Address - Country:US
Mailing Address - Phone:330-758-0577
Mailing Address - Fax:330-758-0466
Practice Address - Street 1:8591 CROSSROADS DRIVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514
Practice Address - Country:US
Practice Address - Phone:330-758-0577
Practice Address - Fax:330-758-0466
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028392363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner