Healthcare Provider Details

I. General information

NPI: 1154056604
Provider Name (Legal Business Name): LORI FAYE MCDOWELL BSN, RN, MSN-FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORI FAYE FERNANDEZ BSN, RN

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 10/12/2023
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ALPINE STREET
COLDSPRING TX
77331
US

IV. Provider business mailing address

141 BAYBERRY DRIVE
LIVINGSTON TX
77351
US

V. Phone/Fax

Practice location:
  • Phone: 936-647-2227
  • Fax: 936-647-2202
Mailing address:
  • Phone: 936-439-3802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number877710
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number877710
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1103902
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: