Provider Demographics
NPI:1750346391
Name:OWENS, DARYL ANN (CRNA)
Entity type:Individual
Prefix:MS
First Name:DARYL
Middle Name:ANN
Last Name:OWENS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 ROSA AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2812
Mailing Address - Country:US
Mailing Address - Phone:504-838-0865
Mailing Address - Fax:504-838-0863
Practice Address - Street 1:649 ROSA AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2812
Practice Address - Country:US
Practice Address - Phone:504-838-0865
Practice Address - Fax:504-838-0863
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA029532367500000X
SC2489367500000X
TN0000011507367500000X
NC199077367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1396559Medicaid
LA45681OtherBLUE CROSS BLUE SHEILD
LA1396559Medicaid