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NPI Code Detail

MEDICARE: JEAN LOWE

MEDICARE:   JEAN  LOWE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist012134NM

General Provider Information

NPI Number : 1013045723
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN LOWE
Provider Business Mailing Address
First Line : 2925 SANTA CRUZ AVE SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-2948
Country : US
Telephone Number : 505-269-2538
Fax Number :
Provider Business Practice Location Address
First Line : 2925 SANTA CRUZ SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106
Country : US
Telephone Number : 505-269-2538
Fax Number : 505-272-6845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 07/08/2007

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Directions to “ JEAN LOWE ” Practice Location

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