Individual
AUDRA OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
102 N BROADWAY ST, JOHNSON CITY, TN 37601-3525
(423) 588-9978
Mailing address
3919 GREENWOOD DR APT B, JONESBOROUGH, TN 37659-6256
(423) 863-8822
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
77843
TN
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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