Provider Demographics
NPI:1225308521
Name:OWENS, WILHELMINA
Entity Type:Individual
Prefix:
First Name:WILHELMINA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 LEE ROAD S
Mailing Address - Street 2:APT 101
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-4539
Mailing Address - Country:US
Mailing Address - Phone:216-769-3183
Mailing Address - Fax:216-769-3183
Practice Address - Street 1:6200 LEE RD S
Practice Address - Street 2:APT 101
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-4539
Practice Address - Country:US
Practice Address - Phone:216-769-3183
Practice Address - Fax:216-769-3183
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN234499163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse