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NPI Code Detail

MEDICARE: DEANNA LA SHUN OWENS

MEDICARE: DEANNA LA SHUN OWENS
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
13747P1801XPersonal Care Attendant5337AZ

General Provider Information

NPI Number : 1205380003
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA LA SHUN OWENS
Provider Business Mailing Address
First Line : 1933 W BURGESS LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-5440
Country : US
Telephone Number : 602-295-5684
Fax Number :
Provider Business Practice Location Address
First Line : 1933 W BURGESS LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-5440
Country : US
Telephone Number : 602-295-5684
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2016
Last Update Date : 08/09/2016

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Directions to “ DEANNA LA SHUN OWENS ” Practice Location

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