Provider Demographics
NPI:1326268228
Name:LOWERY, PATRICIA DAWN (BS, CLC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DAWN
Last Name:LOWERY
Suffix:
Gender:F
Credentials:BS, CLC
Other - Prefix:MRS
Other - First Name:TRICIA
Other - Middle Name:DAWN
Other - Last Name:LOWERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, CLC
Mailing Address - Street 1:7 SIESTA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3108
Mailing Address - Country:US
Mailing Address - Phone:731-423-4051
Mailing Address - Fax:
Practice Address - Street 1:804 N PARKWAY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3058
Practice Address - Country:US
Practice Address - Phone:731-423-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education