Provider Demographics
NPI:1750067872
Name:LOWTHER, ABBIE JO (FNP)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:JO
Last Name:LOWTHER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 KLIENS RUN RD
Mailing Address - Street 2:
Mailing Address - City:ALUM BRIDGE
Mailing Address - State:WV
Mailing Address - Zip Code:26321-9631
Mailing Address - Country:US
Mailing Address - Phone:304-476-0356
Mailing Address - Fax:
Practice Address - Street 1:376 HWY 5E
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:WV
Practice Address - Zip Code:26351
Practice Address - Country:US
Practice Address - Phone:304-462-7322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV116228363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily