Provider Demographics
NPI:1154056604
Name:MCDOWELL, LORI FAYE (BSN, RN, MSN-FNP-C)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:FAYE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:BSN, RN, MSN-FNP-C
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:FAYE
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:141 BAYBERRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351
Mailing Address - Country:US
Mailing Address - Phone:936-439-3802
Mailing Address - Fax:
Practice Address - Street 1:21 ALPINE STREET
Practice Address - Street 2:
Practice Address - City:COLDSPRING
Practice Address - State:TX
Practice Address - Zip Code:77331
Practice Address - Country:US
Practice Address - Phone:936-647-2227
Practice Address - Fax:936-647-2202
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX877710163W00000X, 163WE0003X
TX390200000X
TX1103902363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program