Provider Demographics
NPI:1629519475
Name:LOWE, NATALIE M (PHD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:LOWE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:M
Other - Last Name:KLEMPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:744 HEARTLAND TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1982
Mailing Address - Country:US
Mailing Address - Phone:608-294-6008
Mailing Address - Fax:608-824-2675
Practice Address - Street 1:744 HEARTLAND TRL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1982
Practice Address - Country:US
Practice Address - Phone:608-294-6008
Practice Address - Fax:608-824-2675
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI3593103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1629519475Medicaid