Provider Demographics
NPI:1346397346
Name:LOWERY, DEBORAH BARGER (CRNA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:BARGER
Last Name:LOWERY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PATEWOOD DR STE B200
Mailing Address - Street 2:GASTROENTEROLOGY ASSOCIATES
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6321
Mailing Address - Country:US
Mailing Address - Phone:864-232-7338
Mailing Address - Fax:864-239-6645
Practice Address - Street 1:200 PATEWOOD DR
Practice Address - Street 2:SUITE B200
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3593
Practice Address - Country:US
Practice Address - Phone:864-232-7338
Practice Address - Fax:864-239-6645
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC68180367500000X
SC3095367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAN1561Medicaid
SCAN1561Medicaid