Provider Demographics
NPI:1912631425
Name:OWENS, DANNI DENISE (FNP)
Entity Type:Individual
Prefix:
First Name:DANNI
Middle Name:DENISE
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 1:2817 RAWHIDE DR
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-7819
Mailing Address - Country:US
Mailing Address - Phone:928-279-5076
Mailing Address - Fax:
Practice Address - Street 1:1858 GOLDEN GATE AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-4055
Practice Address - Country:US
Practice Address - Phone:928-529-5349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP280325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily