Healthcare Provider Details

I. General information

NPI: 1750965539
Provider Name (Legal Business Name): KRISTINA TERESA MARIE OWINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2021
Last Update Date: 05/08/2021
Certification Date: 05/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13500 LITTLE COLA RD
ROCKBRIDGE OH
43149-9730
US

IV. Provider business mailing address

13642 LITTLE COLA RD
ROCKBRIDGE OH
43149-9730
US

V. Phone/Fax

Practice location:
  • Phone: 740-332-6982
  • Fax:
Mailing address:
  • Phone: 740-270-8853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number0093957
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: