Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN164261 | GA |
NPI | 1003304981 |
---|---|
Provider Name | Jennifer Lynn Lowe |
First Address | Hazlehurst, GA 31539-6323 |
Second Address | Hazlehurst, GA 31539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2018 |
Last Update Date | 23/08/2018 |