Provider Demographics
NPI:1962974675
Name:OWENS, JENNY R (LPN)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:R
Last Name:OWENS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43968-1029
Mailing Address - Country:US
Mailing Address - Phone:330-953-0243
Mailing Address - Fax:
Practice Address - Street 1:9955 UNION RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:OH
Practice Address - Zip Code:44455-9763
Practice Address - Country:US
Practice Address - Phone:330-953-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH140724164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse