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NPI Code Detail

MEDICARE: SUE B OWEN CNM

MEDICARE: SUE B OWEN CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife124WV

General Provider Information

NPI Number : 1780614040
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUE B OWEN CNM
Provider Business Mailing Address
First Line : 1 AMALIA DR
Second Line :
City : BUCKHANNON
State : WV
Zip : 26201-2239
Country : US
Telephone Number : 304-472-7473
Fax Number : 304-472-0533
Provider Business Practice Location Address
First Line : 1 AMALIA DR
Second Line :
City : BUCKHANNON
State : WV
Zip : 26201-2239
Country : US
Telephone Number : 304-472-7473
Fax Number : 304-472-0533
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 01/31/2013

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Directions to “ SUE B OWEN CNM” Practice Location

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