Provider Demographics
NPI:1457052821
Name:LOWE, SUNNY DAWN (CRNP)
Entity type:Individual
Prefix:MS
First Name:SUNNY
Middle Name:DAWN
Last Name:LOWE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:SUNNY
Other - Middle Name:DAWN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1978
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1978
Mailing Address - Country:US
Mailing Address - Phone:410-749-1015
Mailing Address - Fax:410-749-0654
Practice Address - Street 1:31413 WINTERPLACE PKWY STE 103
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1877
Practice Address - Country:US
Practice Address - Phone:410-860-0100
Practice Address - Fax:410-860-4894
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid