Healthcare Provider Details

I. General information

NPI: 1053556860
Provider Name (Legal Business Name): LYNN MARIE LOWE RN. MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2008
Last Update Date: 12/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD BLDG. 215-3 RM. 241
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

30269 JASMINE VALLEY DR
CANYON COUNTRY CA
91387-1533
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-3711
  • Fax: 310-268-3543
Mailing address:
  • Phone: 661-250-1040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number525001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: