Provider Demographics
NPI:1407827488
Name:OWENS, CHRISTINA M (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:OWENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:22 BRAMHALL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3104
Practice Address - Country:US
Practice Address - Phone:207-662-2934
Practice Address - Fax:207-662-6389
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME035561363L00000X
MECNP81464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MENP416303Medicare PIN
MEP88335Medicare UPIN
MENP4163Medicare ID - Type Unspecified