Provider Demographics
NPI:1912296369
Name:LOWE, PRISCILLA A (NP)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:A
Last Name:LOWE
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 W STONE DR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3365
Mailing Address - Country:US
Mailing Address - Phone:423-408-7220
Mailing Address - Fax:423-408-7405
Practice Address - Street 1:1 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 200E
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-7459
Practice Address - Country:US
Practice Address - Phone:423-844-5100
Practice Address - Fax:423-844-5109
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2013-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN15775363LF0000X
VA0024170901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV9765BMedicare PIN
TN103I502853Medicare PIN
TN103I502832Medicare PIN