Healthcare Provider Details

I. General information

NPI: 1710729116
Provider Name (Legal Business Name): TIFFANY LOWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 N MAIN ST
CEDAR CITY UT
84721-9746
US

IV. Provider business mailing address

PO BOX 2014
PAROWAN UT
84761-2014
US

V. Phone/Fax

Practice location:
  • Phone: 435-868-5000
  • Fax:
Mailing address:
  • Phone: 435-590-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06260662
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number8888838-3102
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2481307
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: