Provider Demographics
NPI:1487690145
Name:LOWE, GREGG STEVEN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:GREGG
Middle Name:STEVEN
Last Name:LOWE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4516 E JUNIPER DR
Mailing Address - Street 2:APT H
Mailing Address - City:U S A F ACADEMY
Mailing Address - State:CO
Mailing Address - Zip Code:80840-1258
Mailing Address - Country:US
Mailing Address - Phone:719-472-0590
Mailing Address - Fax:
Practice Address - Street 1:4102 PINION DR
Practice Address - Street 2:10TH MEDICAL GROUP
Practice Address - City:U S A F ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-2502
Practice Address - Country:US
Practice Address - Phone:719-333-5691
Practice Address - Fax:719-333-2991
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX526015163W00000X
TX51822367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered