Healthcare Provider Details

I. General information

NPI: 1881800431
Provider Name (Legal Business Name): JANET KAY LOWDER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W CHICAGO ST
SHAWNEE OK
74804-2800
US

IV. Provider business mailing address

101 N UNION AVE
SHAWNEE OK
74801-7067
US

V. Phone/Fax

Practice location:
  • Phone: 405-273-4772
  • Fax:
Mailing address:
  • Phone: 405-878-1135
  • Fax: 405-878-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR0039564
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: