Provider Demographics
NPI: | 1689049306 |
---|---|
Name: | OWOEYE, MARIE O (APRN-CNP) |
Entity type: | Individual |
Prefix: | |
First Name: | MARIE |
Middle Name: | O |
Last Name: | OWOEYE |
Suffix: | |
Gender: | F |
Credentials: | APRN-CNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 700 ACKERMAN RD STE 2120 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBUS |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43202-1559 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 614-293-4243 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6100 N HAMILTON RD FL 3 |
Practice Address - Street 2: | |
Practice Address - City: | WESTERVILLE |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43081-2062 |
Practice Address - Country: | US |
Practice Address - Phone: | 614-293-4243 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2015-12-07 |
Last Update Date: | 2025-02-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 363LF0000X | 363L00000X |
OH | APRN.CNP.18347 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 0151863 | Medicaid | |
OH | 0151863 | Medicaid |