Provider Demographics
NPI:1831269216
Name:OWENS, KARA L (RN-C,MS,WHNP)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:L
Last Name:OWENS
Suffix:
Gender:F
Credentials:RN-C,MS,WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-3905
Mailing Address - Country:US
Mailing Address - Phone:309-478-1700
Mailing Address - Fax:309-478-1701
Practice Address - Street 1:2401 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-3905
Practice Address - Country:US
Practice Address - Phone:309-478-1700
Practice Address - Fax:309-478-1701
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist