Provider Demographics
NPI:1366779704
Name:OWENS, ANGELA P (NP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:P
Last Name:OWENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:P
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5087 STEMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8935
Mailing Address - Country:US
Mailing Address - Phone:901-338-6951
Mailing Address - Fax:909-550-0657
Practice Address - Street 1:5087 STEMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38002-8935
Practice Address - Country:US
Practice Address - Phone:901-351-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108827363LF0000X
TN14567363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily