Provider Demographics
NPI:1972198828
Name:OWENS, KATHY VIRGINIA
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:VIRGINIA
Last Name:OWENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 SCARLET OAK DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-8298
Mailing Address - Country:US
Mailing Address - Phone:606-260-3486
Mailing Address - Fax:
Practice Address - Street 1:422 SCARLET OAK DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-8298
Practice Address - Country:US
Practice Address - Phone:606-260-3486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider