Provider Demographics
NPI:1770910341
Name:OWENS, ROSE M (ARNP)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:M
Last Name:OWENS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1317 HAMMOCK SHADE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-2315
Mailing Address - Country:US
Mailing Address - Phone:863-670-6159
Mailing Address - Fax:
Practice Address - Street 1:1317 HAMMOCK SHADE DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-2315
Practice Address - Country:US
Practice Address - Phone:863-670-6159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1387792363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care