Healthcare Provider Details

I. General information

NPI: 1972175941
Provider Name (Legal Business Name): SUZANNE LOWE CNM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2021
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 ATWOOD AVE STE 442
JOHNSTON RI
02919-3228
US

IV. Provider business mailing address

86 ROOSEVELT RD
CUMBERLAND RI
02864-3421
US

V. Phone/Fax

Practice location:
  • Phone: 401-644-6451
  • Fax:
Mailing address:
  • Phone: 401-644-6451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUZANNE LOWE
Title or Position: PRESIDENT
Credential: CNM
Phone: 401-644-6451