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General NPI Number Information
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NPI Number | 1386038099
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Entity Type | Individual
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Provider Name | MYOSHI OWENS NP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1530 S PROVIDENCE RD
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City | WAXHAW
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State | NC
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Zip | 28173-8313
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Country | US
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Telephone | 704-627-8365
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 601843
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City | CHARLOTTE
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State | NC
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Zip | 28260-1843
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Country | US
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Telephone | 704-627-8365
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5007801
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5007801
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN269731
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95002291
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License Number State | CA
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