Individual
STACY JO OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2240 W SUNSET ST STE 104, SPRINGFIELD, MO 65807-6041
(417) 269-4663
(417) 269-0692
Mailing address
2240 W SUNSET ST STE 104, SPRINGFIELD, MO 65807-6041
(417) 269-4663
(417) 269-0692
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2004029814
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429411218
—
MO
Enumeration date
11/09/2006
Last updated
06/08/2023
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