Healthcare Provider Details

I. General information

NPI: 1841902806
Provider Name (Legal Business Name): ASIA CLAIR SYROYIA OWENS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASIA CLAIRE SYROYIA OWENS PMHNP

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 COURTHOUSE RD STE 202
CHESTERFIELD VA
23832-6687
US

IV. Provider business mailing address

5042 GLEN CANYON DR
VIRGINIA BEACH VA
23462-3665
US

V. Phone/Fax

Practice location:
  • Phone: 804-616-4378
  • Fax:
Mailing address:
  • Phone: 757-237-8658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024186085
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: