Provider Demographics
NPI:1932487014
Name:LOWENBERG, EMILY WHEELWRIGHT (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:WHEELWRIGHT
Last Name:LOWENBERG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:960 MASSACHUSETTS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:617-414-5405
Mailing Address - Fax:
Practice Address - Street 1:BRIGHTON HIGH SCHOOL
Practice Address - Street 2:25 WARREN STREET
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2755
Practice Address - Country:US
Practice Address - Phone:617-635-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-24
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily