Provider Demographics
NPI:1417605189
Name:OWENS, LINDSEY B (NP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:B
Last Name:OWENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 SHALLOWFORD RD STE 1300
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-7033
Mailing Address - Country:US
Mailing Address - Phone:678-560-7160
Mailing Address - Fax:
Practice Address - Street 1:3225 SHALLOWFORD RD STE 1300
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-7033
Practice Address - Country:US
Practice Address - Phone:678-560-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-12
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN212480363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics