Healthcare Provider Details

I. General information

NPI: 1619848827
Provider Name (Legal Business Name): JENNA OWENS AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E 23RD AVE
HUTCHINSON KS
67502-9907
US

IV. Provider business mailing address

1701 E 23RD AVE
HUTCHINSON KS
67502-9907
US

V. Phone/Fax

Practice location:
  • Phone: 620-513-3666
  • Fax: 620-513-3634
Mailing address:
  • Phone: 620-513-3666
  • Fax: 620-513-3634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number53-84756-111
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number53-84756-111
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: