MEDICARE: MRS. ELISABETH ISENHOUR OWENS ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	NCID5002420	NC
2	363L00000X	Nurse Practitioner	5002420	NC

General Provider Information

NPI Number	:	1013177252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELISABETH ISENHOUR OWENS ACNP

Provider Business Mailing Address
First Line	:	3700 BARRETT DR STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7172
Country	:	US
Telephone Number	:	919-231-3966
Fax Number	:	919-231-3912

Provider Business Practice Location Address
First Line	:	3700 BARRETT DR STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7172
Country	:	US
Telephone Number	:	919-231-3966
Fax Number	:	919-231-3912

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	02/12/2025

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