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General NPI Number Information
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NPI Number | 1225208952
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Entity Type | Individual
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Provider Name | AUTUMN LOWEN APRN
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Gender | Female
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 530 N RIDGE RD STE B
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City | WICHITA
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State | KS
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Zip | 67212-6576
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Country | US
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Telephone | 316-616-1055
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Fax | 855-633-0585
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Provider Business Mailing Address
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Address Line | PO BOX 929
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City | CHICKASHA
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State | OK
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Zip | 73023-0929
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Country | US
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Telephone | 405-896-8058
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Fax | 855-223-1999
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 46149
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License Number State | KS
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