Provider Demographics
NPI:1568897056
Name:OWSIANY, JAMIE REBECCA (PA-X)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:REBECCA
Last Name:OWSIANY
Suffix:
Gender:F
Credentials:PA-X
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N PAGE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-4147
Mailing Address - Country:US
Mailing Address - Phone:706-399-1304
Mailing Address - Fax:
Practice Address - Street 1:2864 WOODRUFF ST
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28302
Practice Address - Country:US
Practice Address - Phone:910-570-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant