Healthcare Provider Details

I. General information

NPI: 1871181719
Provider Name (Legal Business Name): LEAH KATHLEEN LOWE DNP, APRN, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 CENTERVIEW BLVD
KISSIMMEE FL
34741-7651
US

IV. Provider business mailing address

10140 CENTURION PKWY N
JACKSONVILLE FL
32256-0532
US

V. Phone/Fax

Practice location:
  • Phone: 407-850-3497
  • Fax:
Mailing address:
  • Phone: 904-697-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberAPRN11009328
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberAPRN11009328
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: