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General NPI Number Information
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NPI Number | 1013551076
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Entity Type | Individual
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Provider Name | MICHELLE LOWERY AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/03/2019
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Last Update Date | 11/03/2019
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Provider Practice Location Address
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Address Line | 805 E PEACH ST
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City | ROWLAND
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State | NC
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Zip | 28383-8613
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Country | US
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Telephone | 910-422-9659
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Fax |
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Provider Business Mailing Address
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Address Line | 10175 LITTLE PATUXENT PKWY
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City | COLUMBIA
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State | MD
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Zip | 21044-2655
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Country | US
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Telephone | 443-492-5115
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AG10190086
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License Number State | NC
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