NPI 1417375916

Gwendolyn Owens

Practitioner Driver Fort Wayne, IN

Practice location

Address: 4821 Pocono Xing, Fort Wayne, IN 46808-3570
Phone: (260) 222-1620

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 172A00000X (IN)

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Registry record

NPI: 1417375916
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Apr 2014
Record last updated: 1 Apr 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.