Provider Demographics
NPI:1952486888
Name:LOWE, REBECCA (LPN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 IVEY RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:GA
Mailing Address - Zip Code:30828-5055
Mailing Address - Country:US
Mailing Address - Phone:706-465-1302
Mailing Address - Fax:
Practice Address - Street 1:510 LEGION DRIVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:GA
Practice Address - Zip Code:30828
Practice Address - Country:US
Practice Address - Phone:706-465-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN042883164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse