Healthcare Provider Details

I. General information

NPI: 1609758911
Provider Name (Legal Business Name): CAMERON OWENS MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CENTER DR STE 100
NORFOLK VA
23502-0002
US

IV. Provider business mailing address

PO BOX 621631
ORLANDO FL
32862-1631
US

V. Phone/Fax

Practice location:
  • Phone: 759-908-3754
  • Fax: 757-767-7783
Mailing address:
  • Phone: 907-957-3211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number00024194328
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: