Provider Demographics
NPI:1871470294
Name:OWENS, AMANDA (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:525 W 15TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2716
Mailing Address - Country:US
Mailing Address - Phone:719-296-6018
Mailing Address - Fax:719-631-6022
Practice Address - Street 1:525 W 15TH ST STE 200
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2716
Practice Address - Country:US
Practice Address - Phone:719-296-6018
Practice Address - Fax:719-631-6022
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO318551163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology