Provider Demographics
NPI:1922511492
Name:OWEN, SARA L (ARNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:OWEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:L
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:5820 WINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1821
Mailing Address - Country:US
Mailing Address - Phone:515-643-6150
Mailing Address - Fax:515-643-6149
Practice Address - Street 1:5820 WINWOOD DR
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1821
Practice Address - Country:US
Practice Address - Phone:515-643-6150
Practice Address - Fax:515-643-6149
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA101649363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner