Provider Demographics
NPI:1619220142
Name:DOW, LUCY JOHANNA (MSN, RN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:JOHANNA
Last Name:DOW
Suffix:
Gender:F
Credentials:MSN, RN, APRN, FNP-C
Other - Prefix:MS
Other - First Name:LUCY
Other - Middle Name:JOHANNA
Other - Last Name:HARDIMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1460 N 16TH AVE
Mailing Address - Street 2:#D
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7102
Mailing Address - Country:US
Mailing Address - Phone:509-574-3805
Mailing Address - Fax:
Practice Address - Street 1:1460 N 16TH AVE
Practice Address - Street 2:#D
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7102
Practice Address - Country:US
Practice Address - Phone:509-574-3805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60280718363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily