Healthcare Provider Details

I. General information

NPI: 1689138661
Provider Name (Legal Business Name): JULIANNE CATHERINE OWEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 NE SAINT LUKES BLVD STE 200
LEES SUMMIT MO
64086-6001
US

IV. Provider business mailing address

20 NE SAINT LUKES BLVD STE 200
LEES SUMMIT MO
64086-6001
US

V. Phone/Fax

Practice location:
  • Phone: 816-347-5100
  • Fax: 816-347-5136
Mailing address:
  • Phone: 816-347-5100
  • Fax: 816-347-5136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-124595-041
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021008260
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-79257
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: