Provider Demographics
NPI:1578531778
Name:OWENS, JOANNA R (CRNA)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:R
Last Name:OWENS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:R
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CRNA
Mailing Address - Street 1:1122 NE 13TH ST
Mailing Address - Street 2:ORI 236
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1039
Mailing Address - Country:US
Mailing Address - Phone:405-271-1515
Mailing Address - Fax:
Practice Address - Street 1:920 STANTON L YOUNG BLVD
Practice Address - Street 2:WP 2530
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5020
Practice Address - Country:US
Practice Address - Phone:405-271-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0056277367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered