Provider Demographics
NPI:1669143095
Name:OWENS, JESSICA DIANE (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:DIANE
Last Name:OWENS
Suffix:
Gender:
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 LIME KILN LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5928
Mailing Address - Country:US
Mailing Address - Phone:317-509-5483
Mailing Address - Fax:
Practice Address - Street 1:3806 LIME KILN LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5928
Practice Address - Country:US
Practice Address - Phone:317-509-5483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016652363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily