Healthcare Provider Details

I. General information

NPI: 1679969828
Provider Name (Legal Business Name): ALISHA BETH LOWDEN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 09/26/2023
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE NM
87120-2682
US

IV. Provider business mailing address

1815 TRUCHAS PEAK TRL NE
RIO RANCHO NM
87144-1008
US

V. Phone/Fax

Practice location:
  • Phone: 505-322-6687
  • Fax:
Mailing address:
  • Phone: 505-923-6770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-03191
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: