Provider Demographics
NPI:1669086898
Name:LOWRY, SHELLY (APRN)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:
Last Name:LOWRY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19680 MCCORD RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72727-8932
Mailing Address - Country:US
Mailing Address - Phone:479-466-9097
Mailing Address - Fax:
Practice Address - Street 1:19680 MCCORD RD
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:AR
Practice Address - Zip Code:72727-8932
Practice Address - Country:US
Practice Address - Phone:479-466-9097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR121858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily