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Individual

MRS. KELLEY M OWSLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
HOME HEALTH AIDE

Contact information

Practice address
1207 SOUTHGATE LN APT A, JEFFERSON CITY, MO 65109-2465
(573) 636-9710
Mailing address
1601 STADIUM BLVD, JEFFERSON CITY, MO 65109-2417
(573) 690-8539

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
20222510P
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20222510P
NATIONAL CERTIFICATION OF HOME HEALTH AIDE
MO
Enumeration date
11/29/2022
Last updated
11/29/2022
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