Provider Demographics
NPI:1750339560
Name:LOWE, KRISTINA ANN (PA)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANN
Last Name:LOWE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:ANN
Other - Last Name:HAMMOND-LOWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:7130 DUNHILL TER NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-1221
Mailing Address - Country:US
Mailing Address - Phone:678-441-9048
Mailing Address - Fax:
Practice Address - Street 1:2985 GEORGE BUSBEE PKWY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6812
Practice Address - Country:US
Practice Address - Phone:404-785-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002923363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical