Provider Demographics
NPI:1104570092
Name:LOWERY, DEENA (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:LOWERY
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:DEENA
Other - Middle Name:MARIE
Other - Last Name:SHELLENBARGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:4655 SALISBURY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0902
Mailing Address - Country:US
Mailing Address - Phone:352-293-2833
Mailing Address - Fax:352-293-2834
Practice Address - Street 1:4655 SALISBURY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0902
Practice Address - Country:US
Practice Address - Phone:352-293-2833
Practice Address - Fax:352-293-2834
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11017029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily