Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5002420 | NC |
N | 363LA2100X | Nurse Practitioner - Acute Care | NCID5002420 | NC |
NPI | 1013177252 |
---|---|
Provider Name | Mrs. Elisabeth Isenhour Owens |
First Address | Raleigh, NC 27610-2989 |
Second Address | Raleigh, NC 27610-2989 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MO1514769 | DEA (01) | NC |