Basic Information
Provider Information
NPI: 1588056667
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OWNBEY
FirstName: WENDY
MiddleName: HANNAH
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1035 E JEFFERSON ST
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850342295
CountryCode: US
TelephoneNumber: 6022510650
FaxNumber: 6023961211
Practice Location
Address1: 1035 E JEFFERSON ST
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850342295
CountryCode: US
TelephoneNumber: 6022510650
FaxNumber: 6023961211
Other Information
ProviderEnumerationDate: 02/26/2015
LastUpdateDate: 02/26/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808XRN179921AZY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


Home