Provider Demographics
NPI:1316074925
Name:OWENS, VIRGINIA MURRAY (PMHNP,BC)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MURRAY
Last Name:OWENS
Suffix:
Gender:F
Credentials:PMHNP,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 HOBCAW DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2545
Mailing Address - Country:US
Mailing Address - Phone:843-884-9606
Mailing Address - Fax:843-884-9606
Practice Address - Street 1:886 JOHNNIE DODDS BLVD UNIT 100
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3190
Practice Address - Country:US
Practice Address - Phone:843-819-5973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2012-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 1107363LF0000X
SCAPRN 1107363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily