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Individual

MRS. LAURA BORDERS OWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
8800 N TRYON ST, CHARLOTTE, NC 28262-3300
(704) 863-5665
(704) 863-5848
Mailing address
4400 GOLF ACRES DRIVE SUITE A, CHARLOTTE, NC 28208-5906
(704) 512-6428

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
89633
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
089633
RN LICIENCE
NC
01
42275
ANNA LICENCE
05
8050667
NC
05
NAN706
SC
Enumeration date
06/30/2006
Last updated
10/05/2017
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