Vicky J. Owens, FNP

Individual provider Active NPI Family Nurse Practitioner · Ava, MO

NPI 1811079734 · NPPES record last updated Jul 15, 2008

Key facts

NPI
1811079734
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
122348 (MO)
Practice address
1312 North Highway 5
Ava, MO 65608
Phone
(417) 683-4045
Fax
(417) 683-6069
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 122348 MO Yes

Addresses

Primary practice location

1312 North Highway 5
Ava, MO 65608

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers

IdentifierTypeStateIssuer
425100203MedicaidMO

Other providers in Ava, MO

All providers in Ava, MO · Family Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.