Individual
MRS. NANCY L OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
1091 S BEACON BLVD, GRAND HAVEN, MI 49417-2607
(616) 604-0096
(616) 604-0095
Mailing address
17700 W SPRING LAKE RD, SPRING LAKE, MI 49456-1448
(616) 846-7535
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704097658
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4682052-10
—
MI
01
—
NO097658
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/27/2005
Last updated
09/13/2012
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