Individual
TAMATHA NICOLE OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HIGHWAY 35 S, FOREST, MS 39074
(931) 253-1110
Mailing address
PO BOX 1258, WAYNESBORO, TN 38485-1258
(931) 253-1110
(256) 664-4280
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
903572
MS
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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