Provider Demographics
NPI:1427017227
Name:LOWERY, NANCY ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:LOWERY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ANN
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 740209
Mailing Address - Street 2:DEPT 1029
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0209
Mailing Address - Country:US
Mailing Address - Phone:941-360-1566
Mailing Address - Fax:941-358-9818
Practice Address - Street 1:550 PEACHTREE STREET
Practice Address - Street 2:SUITE 1600
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2209
Practice Address - Country:US
Practice Address - Phone:404-253-6820
Practice Address - Fax:404-874-1249
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN162038367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000977193Medicaid
GA000977193Medicaid