Provider Demographics
NPI:1770119273
Name:OWENS, ASHLEIGH ROSE (RN)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:ROSE
Last Name:OWENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 6TH ST E APT 717
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1967
Mailing Address - Country:US
Mailing Address - Phone:907-232-9604
Mailing Address - Fax:
Practice Address - Street 1:433 S 7TH ST APT 1923
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1642
Practice Address - Country:US
Practice Address - Phone:907-232-9604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2473822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse