Provider Demographics
NPI:1255085619
Name:ROSE, LORI LOWE
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:LOWE
Last Name:ROSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5823 BOWEN DANIEL DR UNIT 604
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-1476
Mailing Address - Country:US
Mailing Address - Phone:646-483-8341
Mailing Address - Fax:
Practice Address - Street 1:5823 BOWEN DANIEL DR UNIT 604
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33616-1476
Practice Address - Country:US
Practice Address - Phone:646-483-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula