Provider Demographics
NPI:1629248505
Name:OWENS, SHANEE D (NP)
Entity Type:Individual
Prefix:MS
First Name:SHANEE
Middle Name:D
Last Name:OWENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:979 E. THIRD STREET
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403
Mailing Address - Country:US
Mailing Address - Phone:423-778-8179
Mailing Address - Fax:423-778-8180
Practice Address - Street 1:979 E. THIRD STREET
Practice Address - Street 2:SUITE# B.601
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-778-8179
Practice Address - Fax:423-778-8180
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN70373163W00000X, 363LF0000X
TN13255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse