Provider Demographics
NPI:1740917848
Name:OWENS, AMY (FNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5370 WATKINS GLEN CIR E APT 206
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4974
Mailing Address - Country:US
Mailing Address - Phone:901-620-9480
Mailing Address - Fax:
Practice Address - Street 1:1660 BONNIE LN STE 105
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0519
Practice Address - Country:US
Practice Address - Phone:901-620-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN167096163WX0003X
TN32344363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient