Provider Demographics
NPI:1912007857
Name:WARREN, KATE MARIE (DPT)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:MARIE
Last Name:WARREN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:MARIE
Other - Last Name:OREILLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:7940 E SPEEDWAY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1902
Mailing Address - Country:US
Mailing Address - Phone:520-977-1516
Mailing Address - Fax:520-829-4445
Practice Address - Street 1:7940 E SPEEDWAY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1902
Practice Address - Country:US
Practice Address - Phone:520-977-1516
Practice Address - Fax:520-829-4445
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7343174400000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ121055Medicaid
AZZ144822Medicare UPIN