Provider Demographics
NPI:1275722399
Name:LOWE, ELISABETH ELLEN (RN)
Entity Type:Individual
Prefix:MISS
First Name:ELISABETH
Middle Name:ELLEN
Last Name:LOWE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LINCOLN PL
Mailing Address - Street 2:APT. 4
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-4707
Mailing Address - Country:US
Mailing Address - Phone:845-807-3968
Mailing Address - Fax:
Practice Address - Street 1:2 LINCOLN PL
Practice Address - Street 2:APT. 4
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-4707
Practice Address - Country:US
Practice Address - Phone:845-807-3968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY590023-1311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home