Individual
SHANNON OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 W COLUMBIA ST, FARMINGTON, MO 63640-2902
(314) 606-2422
Mailing address
565 HIGH AVE, SAINT LOUIS, MO 63126-1423
(314) 606-2422
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2015027396
MO
363LG0600X
Gerontology Nurse Practitioner
2015027396
MO
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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