Provider Demographics
NPI:1417569062
Name:OWENS, AARON PATRICK SR (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:PATRICK
Last Name:OWENS
Suffix:SR
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:MR
Other - First Name:AARON
Other - Middle Name:PATRICK
Other - Last Name:OWENS
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:111 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5529
Mailing Address - Country:US
Mailing Address - Phone:410-620-0008
Mailing Address - Fax:
Practice Address - Street 1:111 W HIGH ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5529
Practice Address - Country:US
Practice Address - Phone:410-620-0008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR171556363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health