Provider Demographics
NPI:1508311937
Name:OWENS, JENNIFER DIANE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DIANE
Last Name:OWENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:DIANE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1324 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3784
Mailing Address - Country:US
Mailing Address - Phone:615-794-1542
Mailing Address - Fax:
Practice Address - Street 1:1324 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3784
Practice Address - Country:US
Practice Address - Phone:615-794-1542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000177065163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse