Healthcare Provider Details

I. General information

NPI: 1124762257
Provider Name (Legal Business Name): ASHLEY JANEA OWENS APRN, CNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 MORSE RD
COLUMBUS OH
43229-6501
US

IV. Provider business mailing address

4305 PORTOBELLO DR
COLUMBUS OH
43230-5421
US

V. Phone/Fax

Practice location:
  • Phone: 614-405-9415
  • Fax:
Mailing address:
  • Phone: 330-990-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0031473
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number423607
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: