Provider Demographics
NPI:1396587903
Name:OWENS, YULONDA R (MEDICAL ASSIST/CNA)
Entity type:Individual
Prefix:
First Name:YULONDA
Middle Name:R
Last Name:OWENS
Suffix:
Gender:F
Credentials:MEDICAL ASSIST/CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 RUSSELL CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4654
Mailing Address - Country:US
Mailing Address - Phone:405-754-9393
Mailing Address - Fax:
Practice Address - Street 1:821 RUSSELL CIR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4654
Practice Address - Country:US
Practice Address - Phone:405-754-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK376K00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376K00000XNursing Service Related ProvidersNurse's Aide