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General NPI Number Information
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NPI Number | 1346958147
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Entity Type | Individual
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Provider Name | AMY D LOWER C.N.P.
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Gender | Female
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 5105 SOM CENTER RD
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City | WILLOUGHBY
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State | OH
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Zip | 44094-4203
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Country | US
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Telephone | 440-255-5571
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Fax |
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Provider Business Mailing Address
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Address Line | 9485 MENTOR AVENUE SUITE 210
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City | MENTOR
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State | OH
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Zip | 44060
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Country | US
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Telephone | 440-255-5571
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Fax | 440-205-5744
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN.334200
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0034570
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License Number State | OH
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