Provider Demographics
NPI:1174002604
Name:LOW, JEFFREY D (RN)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:LOW
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2601
Mailing Address - Country:US
Mailing Address - Phone:617-319-2551
Mailing Address - Fax:
Practice Address - Street 1:87 BENNETT ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2601
Practice Address - Country:US
Practice Address - Phone:617-319-2551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH047110-21163W00000X
MARN244621163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse