| NPI | 1780021436 |
|---|---|
| Former Name | NICOLE LYNN OWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009416) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R179324) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0993089) | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2024-02-09 |