Individual
MR. JEREMY WAYNE OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
603 N PROGRESS AVE, SILOAM SPRINGS, AR 72761-4352
(479) 524-4141
(479) 549-2577
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
121399
AR
363L00000X
Nurse Practitioner
Primary
2019035092
MO
Other
Enumeration date
06/25/2019
Last updated
10/30/2019
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