Provider Demographics
NPI:1427804327
Name:OWENS, MARY JOSEPHINE
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JOSEPHINE
Last Name:OWENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 HEMPSTEAD STATION DR APT 202
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3567
Mailing Address - Country:US
Mailing Address - Phone:937-329-4574
Mailing Address - Fax:
Practice Address - Street 1:4024 HEMPSTEAD STATION DR APT 202
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3567
Practice Address - Country:US
Practice Address - Phone:937-329-4574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker