Provider Demographics
NPI:1114698594
Name:LOWE, MICHAEL (APN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:LOWE
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ALEXANDRA WAY LITTLE EGG HARBOR
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08087
Mailing Address - Country:US
Mailing Address - Phone:732-682-5105
Mailing Address - Fax:
Practice Address - Street 1:9 ALEXANDRA WAY LITTLE EGG HARBOR
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08087
Practice Address - Country:US
Practice Address - Phone:732-682-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01184900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner