Provider Demographics
NPI:1104493048
Name:LOWE, ANNA ELIZABETH
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ELIZABETH
Last Name:LOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 W PINE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6797
Mailing Address - Country:US
Mailing Address - Phone:423-215-6558
Mailing Address - Fax:
Practice Address - Street 1:301 LOUIS ST
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-5181
Practice Address - Country:US
Practice Address - Phone:423-246-4600
Practice Address - Fax:423-246-3311
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7519390200000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program