Provider Demographics
NPI:1679930531
Name:WARDEN, JOANNE KILGORE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:KILGORE
Last Name:WARDEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:CAROL
Other - Middle Name:KILGORE
Other - Last Name:WARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1787 BROAD ST
Mailing Address - Street 2:PO BOX 685
Mailing Address - City:LUMPKIN
Mailing Address - State:GA
Mailing Address - Zip Code:31815-3045
Mailing Address - Country:US
Mailing Address - Phone:229-838-4900
Mailing Address - Fax:
Practice Address - Street 1:1787 BROAD ST
Practice Address - Street 2:
Practice Address - City:LUMPKIN
Practice Address - State:GA
Practice Address - Zip Code:31815-3045
Practice Address - Country:US
Practice Address - Phone:229-838-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-24
Last Update Date:2016-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN057457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily