Provider Demographics
NPI:1053556860
Name:LOWE, LYNN MARIE (RN MSN)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MARIE
Last Name:LOWE
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30269 JASMINE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1533
Mailing Address - Country:US
Mailing Address - Phone:661-250-1040
Mailing Address - Fax:
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:BLDG. 215-3 RM. 241
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-478-3711
Practice Address - Fax:310-268-3543
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525001163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice