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General NPI Number Information
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NPI Number | 1982466926
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Entity Type | Individual
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Provider Name | ALEXIS RAVEN LOWE CHW0000000316
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Gender | Female
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 1402 E MCKINLEY ST # A
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City | PHOENIX
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State | AZ
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Zip | 85006-3543
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Country | US
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Telephone | 602-491-3499
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Fax |
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Provider Business Mailing Address
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Address Line | 1402 E MCKINLEY ST # A
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City | PHOENIX
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State | AZ
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Zip | 85006-3543
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Country | US
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Telephone | 602-491-3499
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | CHW0000000316
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License Number State | AZ
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