Provider Demographics
NPI:1558172593
Name:LOWRY, JADA BROOKE (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:BROOKE
Last Name:LOWRY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:60 COMMERCE PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7386
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-775-9165
Practice Address - Street 1:302 MOUNT TABOR RD
Practice Address - Street 2:
Practice Address - City:RED SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28377-6415
Practice Address - Country:US
Practice Address - Phone:910-227-2850
Practice Address - Fax:910-227-2847
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001014996363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant