Healthcare Provider Details

I. General information

NPI: 1538309232
Provider Name (Legal Business Name): DENIKA OWENS REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4911 STATE AVE
KANSAS CITY KS
66102-1749
US

IV. Provider business mailing address

4911 STATE AVE
KANSAS CITY KS
66102-1749
US

V. Phone/Fax

Practice location:
  • Phone: 913-287-8851
  • Fax: 913-287-5431
Mailing address:
  • Phone: 913-287-8851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1382578081
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number2000168770
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: