Provider Demographics
NPI:1275376600
Name:OWENS, JAMES BRADFORD (APRN)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRADFORD
Last Name:OWENS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4336 FLEET DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2394
Mailing Address - Country:US
Mailing Address - Phone:501-295-9507
Mailing Address - Fax:
Practice Address - Street 1:10512 S GLENSTONE PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2966
Practice Address - Country:US
Practice Address - Phone:225-751-5412
Practice Address - Fax:225-751-5847
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA235855363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health