Basic Information
| Provider Information | |||||||||
| NPI: | 1619425519 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOWE | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 673 E VALLEY RD NE | ||||||||
| Address2: | |||||||||
| City: | RYDAL | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301711600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707696524 | ||||||||
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| Practice Location | |||||||||
| Address1: | 21 POINTE NORTH DR | ||||||||
| Address2: | |||||||||
| City: | CARTERSVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301207952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6787210705 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2016 | ||||||||
| LastUpdateDate: | 11/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | RN171911 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.