Healthcare Provider Details

I. General information

NPI: 1487638359
Provider Name (Legal Business Name): JASON S LOWE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MONUMENT RD STE 270
YORK PA
17403
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-741-8250
  • Fax: 717-741-8289
Mailing address:
  • Phone: 717-741-8250
  • Fax: 717-741-8289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN342265L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: