Provider Demographics
NPI:1366783656
Name:OWIE, ISOKEN EDITH (LPN)
Entity type:Individual
Prefix:MRS
First Name:ISOKEN
Middle Name:EDITH
Last Name:OWIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 WOODFORD ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-2723
Mailing Address - Country:US
Mailing Address - Phone:617-818-8943
Mailing Address - Fax:
Practice Address - Street 1:37 WOODFORD ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-2723
Practice Address - Country:US
Practice Address - Phone:617-818-8943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN90138164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse