Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 0024179105 | VA |
NPI | 1013513068 |
---|---|
Provider Name | Mrs. Laura Lowe |
First Address | Rockingham, VA 22801-8679 |
Second Address | Rockingham, VA 22801-8679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2020 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013513068 | (05) | VA |