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General NPI Number Information
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NPI Number | 1922874668
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Entity Type | Individual
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Provider Name | VICTORIA RACHELLE OWENS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 411 OAK ST
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City | RICHTON
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State | MS
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Zip | 39476-7447
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Country | US
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Telephone | 601-408-0719
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Fax |
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Provider Business Mailing Address
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Address Line | 155 CROSS CREEK PKWY APT 722
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City | HATTIESBURG
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State | MS
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Zip | 39402-4429
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Country | US
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Telephone | 601-337-6593
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 906374
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License Number State | MS
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