Basic Information
Provider Information
NPI: 1245592906
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OWENS
FirstName: SHEILA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 219672
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641219672
CountryCode: US
TelephoneNumber: 8167817730
FaxNumber: 8164151886
Practice Location
Address1: 2609 GLENN HENDREN DR
Address2:  
City: LIBERTY
State: MO
PostalCode: 640683313
CountryCode: US
TelephoneNumber: 8167817730
FaxNumber: 8164151886
Other Information
ProviderEnumerationDate: 06/08/2012
LastUpdateDate: 10/23/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X2015018630MOY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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