Jennifer Owens, LAT, ATC
Individual provider Active NPI Athletic Trainer · Portland, CT
NPI 1154933158 · NPPES record last updated Aug 20, 2020
Key facts
- NPI
- 1154933158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1500 (CT)
- Practice address
- 2 Jobs Gate 1
Portland, CT 06480-1750 - Phone
- (860) 919-1113
- NPI assigned
- Aug 20, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1500 | CT | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1500 | CT | Yes |
Addresses
Primary practice location
2 Jobs Gate 1
Portland, CT 06480-1750
Mailing address
2 Jobs Gate 1
Portland, CT 06480-1750
Other providers in Portland, CT
- Kelly Marie Mullen
- Louis R Neumann
- Matthew Nichols
- Sara Oconnell
- Carly M Odesina
- Rupesh Pandey
- Stephen P Paschall
- Vipul Anant Patel
- Michelle M Pellin
- Juliette Piazza
All providers in Portland, CT · Athletic Trainer in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.