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General NPI Number Information
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NPI Number | 1629459938
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Entity Type | Individual
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Provider Name | JESSELL MARIE OWENS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 780 VISTA BLVD STE 100
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City | SPARKS
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State | NV
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Zip | 89434-6677
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Country | US
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Telephone | 775-348-8800
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Fax | 833-687-1419
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Provider Business Mailing Address
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Address Line | 5310 KIETZKE LN STE 104
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City | RENO
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State | NV
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Zip | 89511-2043
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Country | US
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Telephone | 775-348-8800
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Fax | 833-687-1419
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 20924
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License Number State | NV
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