Individual
MARK OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
310 BONITA VISTA BLVD, LOS LUNAS, NM 87031
(505) 565-8755
(505) 565-8762
Mailing address
PO BOX 1300, LOS LUNAS, NM 87031-1300
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
56929
NM
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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