Provider Demographics
NPI:1023540200
Name:LOWTHER, SARAH MAE (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MAE
Last Name:LOWTHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MAE
Other - Last Name:VINING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DARBYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7848
Mailing Address - Country:US
Mailing Address - Phone:540-840-0582
Mailing Address - Fax:
Practice Address - Street 1:ROOM C208 BLDG 19
Practice Address - Street 2:
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22135-0001
Practice Address - Country:US
Practice Address - Phone:703-985-3575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001164264163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health