Provider Demographics
NPI:1467775171
Name:OWENS, KRISTA L (LPN)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:L
Last Name:OWENS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4572 MAYHEW AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-5435
Mailing Address - Country:US
Mailing Address - Phone:513-748-9535
Mailing Address - Fax:
Practice Address - Street 1:4572 MAYHEW AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-5435
Practice Address - Country:US
Practice Address - Phone:513-748-9535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.091634164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse