Healthcare Provider Details

I. General information

NPI: 1871515361
Provider Name (Legal Business Name): CATHERINE JOYCE LOWE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 MICHIGAN AVE
WALKER MN
56484-1390
US

IV. Provider business mailing address

PO BOX 1390
WALKER MN
56484-1390
US

V. Phone/Fax

Practice location:
  • Phone: 218-547-3938
  • Fax: 218-547-3922
Mailing address:
  • Phone: 218-547-3938
  • Fax: 218-547-3922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9218
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: