Healthcare Provider Details

I. General information

NPI: 1952297723
Provider Name (Legal Business Name): CHRISTINA NICOLE OWEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 MUELLER BRASS RD
COVINGTON TN
38019-3754
US

IV. Provider business mailing address

375 DANIEL DR
BRIGHTON TN
38011-6293
US

V. Phone/Fax

Practice location:
  • Phone: 901-476-0235
  • Fax: 901-476-0229
Mailing address:
  • Phone: 901-896-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number213149
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: