Provider Demographics
NPI:1780149906
Name:LOWERY, MELANIE ANNE (AGACNP- BC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANNE
Last Name:LOWERY
Suffix:
Gender:F
Credentials:AGACNP- BC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ANNE
Other - Last Name:NESTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 MERRITT DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5979
Mailing Address - Country:US
Mailing Address - Phone:919-885-6342
Mailing Address - Fax:
Practice Address - Street 1:2100 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2818
Practice Address - Country:US
Practice Address - Phone:252-847-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011418363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care