Healthcare Provider Details

I. General information

NPI: 1720745821
Provider Name (Legal Business Name): ELIZABETH AMY LOWE ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MANCHESTER EXPY STE 1009
COLUMBUS GA
31904-6877
US

IV. Provider business mailing address

2300 MANCHESTER EXPY STE 1009
COLUMBUS GA
31904-6877
US

V. Phone/Fax

Practice location:
  • Phone: 830-214-3217
  • Fax: 833-455-7724
Mailing address:
  • Phone: 830-214-3217
  • Fax: 833-455-7724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP003586
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1059108
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNP003586
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number901200
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1059108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: