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General NPI Number Information
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NPI Number | 1356733513
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Entity Type | Individual
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Provider Name | ELIZABETH BEE OWEN PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/25/2015
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | 902 N HOWE ST
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City | SOUTHPORT
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State | NC
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Zip | 28461-3038
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Country | US
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Telephone | 910-332-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 104 CANON GATE DR
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City | CARY
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State | NC
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Zip | 27518-2403
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Country | US
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Telephone | 919-619-7052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-05585
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License Number State | NC
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