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Individual

MRS. MARIAH KELLY OWENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN

Contact information

Practice address
901 W WARREN AVE, LONGWOOD, FL 32750-4003
(407) 733-6759
Mailing address
901 W WARREN AVE, LONGWOOD, FL 32750-4003
(407) 733-6759

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11037760
FL

Other

Enumeration date
05/13/2025
Last updated
05/13/2025
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