Individual
KENNY T OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
624 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2955
(870) 424-1000
(870) 424-6616
Mailing address
PO BOX 1269, MOUNTAIN HOME, AR 72654-1269
(870) 424-7070
(870) 424-6616
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00131
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115215701
—
AR
01
—
771090601
BREASTCARE
AR
Enumeration date
05/11/2006
Last updated
07/13/2009
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