Healthcare Provider Details

I. General information

NPI: 1316826795
Provider Name (Legal Business Name): CYNTHIA G LOWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

IV. Provider business mailing address

72 WILLOW OAK CIR
COMER GA
30629-3260
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-2502
  • Fax:
Mailing address:
  • Phone: 706-201-6984
  • Fax: 706-201-6984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN150264
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: