Healthcare Provider Details

I. General information

NPI: 1114848652
Provider Name (Legal Business Name): EMMA FAYE OWEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 SOUTHFORK DR
FALMOUTH KY
41040-7964
US

IV. Provider business mailing address

324 SOUTHFORK DR
FALMOUTH KY
41040-7964
US

V. Phone/Fax

Practice location:
  • Phone: 859-760-9883
  • Fax:
Mailing address:
  • Phone: 859-760-9883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: