Healthcare Provider Details

I. General information

NPI: 1326268228
Provider Name (Legal Business Name): PATRICIA DAWN LOWERY B.S., CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRICIA DAWN LOWERY B.S., CLC

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 N PARKWAY
JACKSON TN
38305-3058
US

IV. Provider business mailing address

7 SIESTA DR
JACKSON TN
38305-3108
US

V. Phone/Fax

Practice location:
  • Phone: 731-423-3020
  • Fax:
Mailing address:
  • Phone: 731-423-4051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: