Provider Demographics
NPI:1750313003
Name:OWEN, ANN (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 MILL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1320
Mailing Address - Country:US
Mailing Address - Phone:775-329-1019
Mailing Address - Fax:775-329-1564
Practice Address - Street 1:781 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1320
Practice Address - Country:US
Practice Address - Phone:775-329-1019
Practice Address - Fax:775-329-1564
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8601207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016651Medicaid
NV002016651Medicaid
NVG64792Medicare UPIN