Provider Demographics
NPI:1295602472
Name:OWENS, MARY ELISE (ARNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELISE
Last Name:OWENS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9255
Mailing Address - Fax:
Practice Address - Street 1:160 ADVENTURELAND DR NW STE C
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-4232
Practice Address - Country:US
Practice Address - Phone:515-875-9020
Practice Address - Fax:515-875-9021
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA187696363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner