Provider Demographics
NPI:1588630024
Name:OWENS, KAREN M (CNM)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:OWENS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 E VALLEY RD
Mailing Address - Street 2:ST 105 ALL VALLEY WOMENS CARE
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621
Mailing Address - Country:US
Mailing Address - Phone:970-927-1717
Mailing Address - Fax:970-927-6164
Practice Address - Street 1:1450 E VALLEY RD
Practice Address - Street 2:STE 105 ALL VALLEY WOMENS CARE
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621
Practice Address - Country:US
Practice Address - Phone:970-927-1717
Practice Address - Fax:970-927-6164
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52336176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07523368Medicaid
P22891Medicare UPIN
CO07523368Medicaid