Provider Demographics
NPI:1043780927
Name:OWENS, OLIVIA (LVN)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9707 FM 524 RD
Mailing Address - Street 2:
Mailing Address - City:SWEENY
Mailing Address - State:TX
Mailing Address - Zip Code:77480-8233
Mailing Address - Country:US
Mailing Address - Phone:979-533-1132
Mailing Address - Fax:
Practice Address - Street 1:9707 FM 524 RD
Practice Address - Street 2:
Practice Address - City:SWEENY
Practice Address - State:TX
Practice Address - Zip Code:77480-8233
Practice Address - Country:US
Practice Address - Phone:979-533-1132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX316118164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse