=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578568465
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELEANOR LATRELLE LOWE FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2005
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 902 KIRKWOOD AVE NW
-----------------------------------------------------
City | LENOIR
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28645-5121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 287-540-1018
-----------------------------------------------------
Fax | 828-757-0402
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 902 KIRKWOOD AVE NW
-----------------------------------------------------
City | LENOIR
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28645-5121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-754-0101
-----------------------------------------------------
Fax | 828-757-0402
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 200096
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 200096
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------