Provider Demographics
NPI:1063536084
Name:OWENS, JOAN LORRAINE (RN)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:LORRAINE
Last Name:OWENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59745 OLIVER HTS. LN
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-3501
Mailing Address - Country:US
Mailing Address - Phone:503-366-1731
Mailing Address - Fax:
Practice Address - Street 1:59745 OLIVER HTS. LN
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-3501
Practice Address - Country:US
Practice Address - Phone:503-366-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200442304RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse