Provider Demographics
NPI:1427216639
Name:OWEN, MARIA GERTRUDES (RN)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:GERTRUDES
Last Name:OWEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 LINHART AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-6058
Mailing Address - Country:US
Mailing Address - Phone:239-848-0479
Mailing Address - Fax:
Practice Address - Street 1:2295 VICTORIA AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-3884
Practice Address - Country:US
Practice Address - Phone:239-338-1350
Practice Address - Fax:239-338-1355
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2948282163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse