Provider Demographics
NPI:1568820595
Name:OWENS, JENNIFER R (AGNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:OWENS
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HUNT ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4426
Mailing Address - Country:US
Mailing Address - Phone:781-867-2050
Mailing Address - Fax:
Practice Address - Street 1:22 HUNT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4426
Practice Address - Country:US
Practice Address - Phone:781-867-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2262174363L00000X, 163W00000X
NH086867-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse