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NPI Code Detail

MEDICARE: CHRISTIE MICHELLE OWEN FNP-C

MEDICARE: CHRISTIE MICHELLE OWEN FNP-C
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
1363LF0000XFamily Nurse PractitionerAP141696TX

General Provider Information

NPI Number : 1902463847
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIE MICHELLE OWEN FNP-C
Provider Business Mailing Address
First Line : 6000 BRYANT IRVIN RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4116
Country : US
Telephone Number : 817-229-4375
Fax Number :
Provider Business Practice Location Address
First Line : 6000 BRYANT IRVIN RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4116
Country : US
Telephone Number : 817-229-4375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2019
Last Update Date : 05/29/2019

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