Provider Demographics
NPI:1942380647
Name:LOWE, LORI D (NP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:D
Last Name:LOWE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 LAFAYETTE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-1146
Mailing Address - Country:US
Mailing Address - Phone:317-291-7422
Mailing Address - Fax:317-291-7433
Practice Address - Street 1:3400 LAFAYETTE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-1146
Practice Address - Country:US
Practice Address - Phone:317-291-7422
Practice Address - Fax:317-291-7433
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71001671363LP0200X
IN28115601363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200468960Medicaid
IN200468960Medicaid
IN145590J4Medicare PIN