Individual
SUSIE LYNN OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 778-4159
(573) 778-4294
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 778-4159
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN112545
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
428194310
—
MO
Enumeration date
09/27/2006
Last updated
01/15/2015
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