Healthcare Provider Details

I. General information

NPI: 1013707736
Provider Name (Legal Business Name): BARBARA OWDZIEJ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 WRIGHT ST
MARQUETTE MI
49855-1955
US

IV. Provider business mailing address

100 MALTON RD
NEGAUNEE MI
49866-2001
US

V. Phone/Fax

Practice location:
  • Phone: 906-228-7611
  • Fax:
Mailing address:
  • Phone: 906-228-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704145598
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: