Provider Demographics
NPI:1891768024
Name:OWEN, DAVID MICHAEL (ARNP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHAEL
Last Name:OWEN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:IA
Mailing Address - Zip Code:51640-1300
Mailing Address - Country:US
Mailing Address - Phone:712-382-2626
Mailing Address - Fax:712-382-1931
Practice Address - Street 1:1219 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:IA
Practice Address - Zip Code:51640-1300
Practice Address - Country:US
Practice Address - Phone:712-382-2626
Practice Address - Fax:712-382-1931
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110745363LF0000X
IAA096018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0476846Medicaid
IA0476846Medicaid
IAI15696Medicare ID - Type Unspecified
Q49638Medicare UPIN