Staci Owen, PA

NPI #1477919074 in Maryville, Tennessee

Provider Information

NPI Number: 1477919074
Entity Type: Individual
Name: Staci Owen, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jan 12, 2016
Last Updated: Dec 11, 2018

Practice Location

Address: 701 MORGANTON SQUARE DR
City: Maryville
State: Tennessee
ZIP Code: 37801-4796
Phone: (865) 984-6823

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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