Provider Demographics
NPI:1497150106
Name:OWEN, PAIGE (ARNP)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:KACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-3595
Mailing Address - Fax:319-356-7659
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-3595
Practice Address - Fax:319-356-7659
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20142314363LP0200X
IAC163934363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics