Basic Information
| Provider Information | |||||||||
| NPI: | 1811237977 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | HOWELL | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1039 BROOKFOREST AVE | ||||||||
| Address2: | |||||||||
| City: | SHOREWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604048849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157335952 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1039 BROOKFOREST AVE | ||||||||
| Address2: | |||||||||
| City: | SHOREWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157335952 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2013 | ||||||||
| LastUpdateDate: | 05/15/2019 | ||||||||
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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 | 363L00000X | 209019191 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.