Healthcare Provider Details

I. General information

NPI: 1568070571
Provider Name (Legal Business Name): HARRISON CHARLES LOWELL APRN-NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2020
Last Update Date: 07/15/2020
Certification Date: 07/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7756 S FLANDERS ST
CENTENNIAL CO
80016-1948
US

IV. Provider business mailing address

7756 S FLANDERS ST
CENTENNIAL CO
80016-1948
US

V. Phone/Fax

Practice location:
  • Phone: 303-204-9910
  • Fax:
Mailing address:
  • Phone: 303-204-9910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN0995698-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: