Doctor Name: | LISA DIANE OWENS |
NPI Number: | 1083697601 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 71001815A |
Business Practice Address: | 188 E Southway Blvd Kokomo, IN - 469023650 |
Business Phone Number: | 7654539000 |
Business Fax Number: | 7654538850 |
Mailing Address: | 10330 N Meridian St, Suite 201 INDIANAPOLIS |
State: | IN |
Postal Code: | 462901024 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/29/2005 |
NPI Last Update Date: | 11/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71001815A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |