Healthcare Provider Details

I. General information

NPI: 1386056463
Provider Name (Legal Business Name): PAMALEE OWENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 ROLLINS AVE
ROCKVILLE MD
20852-5615
US

IV. Provider business mailing address

981 ROLLINS AVE
ROCKVILLE MD
20852-5615
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-1684
  • Fax: 240-777-4169
Mailing address:
  • Phone: 240-777-1684
  • Fax: 240-777-4169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR084737
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: