MEDICARE: ELIZABETH KATHLEEN LOWRY RD, PA-C

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
1	363AM0700X	Medical Physician Assistant	2013033101	MO
2	363A00000X	Physician Assistant	15-01639	KS

General Provider Information

NPI Number	:	1447685375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH KATHLEEN LOWRY RD, PA-C

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD # MS 3105
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8500
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD # MS 3105
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2013
Last Update Date	:	12/06/2018

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