Provider Demographics
NPI:1841539418
Name:OWENS, MONA (ARNP)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 PUTTERS GREEN WAY S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4338
Mailing Address - Country:US
Mailing Address - Phone:904-631-1881
Mailing Address - Fax:904-287-4596
Practice Address - Street 1:729 PUTTERS GREEN WAY S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-4338
Practice Address - Country:US
Practice Address - Phone:904-631-1881
Practice Address - Fax:904-287-4596
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1062982363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health