Provider Demographics
NPI:1437491339
Name:ELLIOTT-OWENS, DENISE CASSANDRA (RN)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:CASSANDRA
Last Name:ELLIOTT-OWENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 GATES AVE APT 1D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-1532
Mailing Address - Country:US
Mailing Address - Phone:917-302-5304
Mailing Address - Fax:
Practice Address - Street 1:590 GATES AVE APT 1D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1532
Practice Address - Country:US
Practice Address - Phone:917-302-5304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY664547-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse