Individual
KACIE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPCNP-BC
Contact information
Practice address
830 PENNSLYVANIA AVENUE, SUITE 103, CHARLESTON, WV 25302-3389
(304) 388-1552
Mailing address
PO BOX 124, ELEANOR, WV 25070-0124
(304) 542-1090
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN78736-CPNP
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810028354
—
WV
Enumeration date
07/31/2014
Last updated
03/17/2018
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