Healthcare Provider Details

I. General information

NPI: 1548365893
Provider Name (Legal Business Name): LOWRY O SIMPSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10511 GOLF COURSE RD NW SUITE 201
ALBUQUERQUE NM
87114-5916
US

IV. Provider business mailing address

10511 GOLF COURSE RD NW SUITE 201
ALBUQUERQUE NM
87114-5916
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-4500
  • Fax: 505-727-4030
Mailing address:
  • Phone: 505-727-4500
  • Fax: 505-727-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number000333
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number657
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: