Provider Demographics
NPI:1295335503
Name:LOWE, JENNIE
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:LOWE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 21ST AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37240-1104
Mailing Address - Country:US
Mailing Address - Phone:302-343-2385
Mailing Address - Fax:
Practice Address - Street 1:128 MARCELLA RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803
Practice Address - Country:US
Practice Address - Phone:302-750-2450
Practice Address - Fax:302-525-6706
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0000221104100000X
DEL1-0074430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163W00000XNursing Service ProvidersRegistered Nurse