Provider Demographics
NPI:1871233957
Name:LOWRY, BREEONNA LEIGH (NP)
Entity Type:Individual
Prefix:
First Name:BREEONNA
Middle Name:LEIGH
Last Name:LOWRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 COMMERCE PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7386
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-775-9165
Practice Address - Street 1:610 E DR MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364-1800
Practice Address - Country:US
Practice Address - Phone:910-844-5253
Practice Address - Fax:910-844-3290
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5015953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily