Provider Demographics
NPI:1982145884
Name:OWINGS, SICILY DAWN (BS)
Entity Type:Individual
Prefix:MISS
First Name:SICILY
Middle Name:DAWN
Last Name:OWINGS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8407 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3809
Mailing Address - Country:US
Mailing Address - Phone:303-487-7776
Mailing Address - Fax:
Practice Address - Street 1:8407 BRYANT ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3809
Practice Address - Country:US
Practice Address - Phone:303-487-7776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1982865580Medicaid