Healthcare Provider Details

I. General information

NPI: 1508794892
Provider Name (Legal Business Name): CHRISTINA MICHELLE OWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 MCADAMS SCHOOL RD
HONEA PATH SC
29654-9591
US

IV. Provider business mailing address

231 MCADAMS SCHOOL RD
HONEA PATH SC
29654-9591
US

V. Phone/Fax

Practice location:
  • Phone: 864-940-8242
  • Fax:
Mailing address:
  • Phone: 864-940-8242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number209822
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: