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General NPI Number Information
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NPI Number | 1508947029
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Entity Type | Individual
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Provider Name | KIMBERLY SUE OWENS OD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 13230 HARRELL PKWY STE 300
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City | NOBLESVILLE
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State | IN
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Zip | 46060-3319
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Country | US
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Telephone | 317-770-1633
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Fax | 317-770-0932
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Provider Business Mailing Address
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Address Line | 6113 SAW MILL DR
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City | NOBLESVILLE
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State | IN
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Zip | 46062-6559
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Country | US
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Telephone | 317-770-1633
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Fax | 317-770-0932
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002533
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18002577
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License Number State | IN
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