Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 09634R | LA |
NPI | 1952480634 |
---|---|
Provider Name | Dr. Ruth Marianne Owens |
First Address | Metairie, LA 70002-5634 |
Second Address | Metairie, LA 70002-5634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E36853 | (02) | LA |