Provider Demographics
NPI:1508325150
Name:OWENS, SEBREENA LYNN (CNA)
Entity Type:Individual
Prefix:MS
First Name:SEBREENA
Middle Name:LYNN
Last Name:OWENS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 DAVIDSON STREET
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001
Mailing Address - Country:US
Mailing Address - Phone:724-630-9471
Mailing Address - Fax:
Practice Address - Street 1:1705 DAVIDSON STREET
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001
Practice Address - Country:US
Practice Address - Phone:724-630-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9603219374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty