Healthcare Provider Details

I. General information

NPI: 1376281535
Provider Name (Legal Business Name): ANNA LEA OWINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 05/26/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10706 STATE ROUTE 93 N
LOGAN OH
43138-9133
US

IV. Provider business mailing address

10607 STATE ROUTE 93 NORTH
LOGAN OH
43138
US

V. Phone/Fax

Practice location:
  • Phone: 740-503-0106
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: