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Individual

AMANDA R. OWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

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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