Provider Demographics
NPI:1053599027
Name:OWENS, MAUREEN ELLEN (RN, CNP, LISW-S)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ELLEN
Last Name:OWENS
Suffix:
Gender:F
Credentials:RN, CNP, LISW-S
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:E
Other - Last Name:ABEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7100 GRAPHICS WAY STE 3100
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-0209
Mailing Address - Country:US
Mailing Address - Phone:740-428-0428
Mailing Address - Fax:
Practice Address - Street 1:7100 GRAPHICS WAY STE 3100
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-0209
Practice Address - Country:US
Practice Address - Phone:740-428-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027966363LF0000X
OH0027966363LF0000X
NM55470363LF0000X
TXAP126817363LF0000X
OHI00058121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0112961Medicaid