Individual
COURTNEY SHAE OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10412 HOLLIE RD, GLEN ST MARY, FL 32040-2565
(904) 408-1402
Mailing address
10412 HOLLIE RD, GLEN ST MARY, FL 32040-2565
(904) 408-1402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11046083
FL
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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