Provider Demographics
NPI:1952675043
Name:LOWE, CHARISSA KIRKLAND (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHARISSA
Middle Name:KIRKLAND
Last Name:LOWE
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Gender:F
Credentials:APRN
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Mailing Address - Street 1:1624 MAIN STREET
Mailing Address - Street 2:AGAPE SENIOR PRIMARY CARE, INC., DBA LTC HEALTH SOLUTIO
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201
Mailing Address - Country:US
Mailing Address - Phone:803-726-2350
Mailing Address - Fax:803-404-6000
Practice Address - Street 1:1614 MAIN STREET SUITE C
Practice Address - Street 2:LTC HEALTH SOLUTIONS
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2818
Practice Address - Country:US
Practice Address - Phone:803-451-6133
Practice Address - Fax:803-726-2210
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2017-02-24
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Provider Licenses
StateLicense IDTaxonomies
SC17716363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care