Provider Demographics
NPI:1164077350
Name:LOWERY, MARIA BREANNE (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:BREANNE
Last Name:LOWERY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5857 21ST AVE W STE A
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5641
Mailing Address - Country:US
Mailing Address - Phone:941-792-0611
Mailing Address - Fax:941-792-0086
Practice Address - Street 1:5857 21ST AVE W STE A
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5641
Practice Address - Country:US
Practice Address - Phone:941-792-0611
Practice Address - Fax:941-792-0086
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily