Healthcare Provider Details

I. General information

NPI: 1265935589
Provider Name (Legal Business Name): JAZMIN LOWE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9711 SHERRILL BLVD STE 201
KNOXVILLE TN
37932
US

IV. Provider business mailing address

307 MCCALL RD
MARYVILLE TN
37804-3058
US

V. Phone/Fax

Practice location:
  • Phone: 865-373-5050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23781
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: