Provider Demographics
NPI:1740405497
Name:LOWER, ANGELA KATHRYN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:KATHRYN
Last Name:LOWER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-353-8122
Mailing Address - Fax:517-432-3713
Practice Address - Street 1:804 SERVICE RD STE A217
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7015
Practice Address - Country:US
Practice Address - Phone:517-353-8122
Practice Address - Fax:517-432-3713
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601004369363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1153313280OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI7526700OtherAETNA
MI1057819OtherMCLAREN HEALTH ADVANTAGE
MI1057819OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI1153313280OtherBLUE CARE NETWORK
MI0N61290012OtherMEDICARE ADVANTAGE
MIP00665146OtherRAILROAD MEDICARE
MI1057819OtherMCLAREN HEALTH PLAN-MEDICAID
MI7526700OtherAETNA