Individual
MS. MARY ELIZABETH OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,IBCLC
Contact information
Practice address
1725 PINE ST, JACKSON HOSPITAL (4 WEST-LACTATION OFFICE), MONTGOMERY, AL 36106-1109
(334) 293-8000
Mailing address
1725 PINE ST, JACKSON HOSPITAL (4 WEST-LACTATION OFFICE), MONTGOMERY, AL 36106-1109
(334) 293-8000
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
IBCLC #108-12747
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-028903
BOARD OF NURSING-RN LICENSE
AL
Enumeration date
05/24/2011
Last updated
05/24/2011
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