MEDICARE: KENNETH J A LOWN ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP2201X	Ambulatory Care Registered Nurse	ARNP9267410	FL
2	163WP2201X	Ambulatory Care Registered Nurse	SP007282	PA
3	363LP0200X	Pediatric Nurse Practitioner	ARNP9267410	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336182039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH J A LOWN ARNP

Provider Business Mailing Address
First Line	:	12945 SPRING RAIN RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5201
Country	:	US
Telephone Number	:	904-501-0216
Fax Number	:

Provider Business Practice Location Address
First Line	:	1679 EAGLE HARBOR PKWY STE B
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-4816
Country	:	US
Telephone Number	:	904-264-1958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	04/10/2025

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Directions to “ KENNETH J A LOWN ARNP” Practice Location

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