Provider Demographics
NPI:1871370551
Name:LOWE, JACQUELINE VERONICA (DNP)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:VERONICA
Last Name:LOWE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:MISS
Other - First Name:JACQUELINE
Other - Middle Name:V
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 74008272
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-8272
Mailing Address - Country:US
Mailing Address - Phone:702-899-0595
Mailing Address - Fax:702-977-1496
Practice Address - Street 1:3905 LORRAINE PATH
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-8630
Practice Address - Country:US
Practice Address - Phone:702-899-0595
Practice Address - Fax:702-977-1496
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704222724363LF0000X
IN71016697A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily