Individual
AMANDA R. OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1301 RING RD, ELIZABETHTOWN, KY 42701-8968
(270) 765-2107
(270) 769-9642
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3005248
KY
363LP0200X
Pediatric Nurse Practitioner
Primary
3005248
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000534238
ANTHEM - CMA
KY
01
—
000023028W
HUMANA - CMA
KY
01
—
093346
SIHO - CMA
KY
01
—
1567385
FIRST HEALTH - CMA
KY
01
—
2861862000
PASSPORT ADVTG - CMA
KY
05
—
300056675
—
IN
01
—
50016143
PASSPORT - CMA
KY
05
—
7100014560
—
KY
01
—
K132010
MEDICARE
KY
Enumeration date
08/07/2007
Last updated
04/24/2024
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