Provider Demographics
NPI:1669135406
Name:LOWE, KRISTEN BRYANNA (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:BRYANNA
Last Name:LOWE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-1625
Mailing Address - Country:US
Mailing Address - Phone:731-415-2168
Mailing Address - Fax:
Practice Address - Street 1:216 DOVER RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-4156
Practice Address - Country:US
Practice Address - Phone:931-436-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45496183500000X, 405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional
No183500000XPharmacy Service ProvidersPharmacist