Provider Demographics
NPI:1528027943
Name:LOWERY, JILL S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:S
Last Name:LOWERY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 FULTON STREET
Mailing Address - Street 2:VA MEDICAL CENTER (116B)
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705
Mailing Address - Country:US
Mailing Address - Phone:919-286-0411
Mailing Address - Fax:919-416-5832
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:VA MEDICAL CENTER (116B)
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:919-416-5832
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2063103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical