Provider Demographics
NPI:1649583535
Name:LOWE, KEVIN MARK (MSN, APRN, ACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:MARK
Last Name:LOWE
Suffix:
Gender:M
Credentials:MSN, APRN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37938
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28237-7938
Mailing Address - Country:US
Mailing Address - Phone:704-332-0396
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:3158 FREEDOM DR STE 3101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-0014
Practice Address - Country:US
Practice Address - Phone:704-332-0396
Practice Address - Fax:704-971-0035
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4185363LA2100X
NC5008413363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3881Medicaid
NC1649583535Medicaid
NCNCS007AMedicare PIN