Basic Information
| Provider Information | |||||||||
| NPI: | 1578683272 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEWLAND OWENS | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | BHRS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 617 E EMPORIA AVE | ||||||||
| Address2: | |||||||||
| City: | PONCA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 746012816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5807655108 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 429 BARNES | ||||||||
| Address2: | |||||||||
| City: | ALVA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803271010 | ||||||||
| FaxNumber: | 5803271010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 06/24/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.