Provider Demographics
NPI:1104917269
Name:LOWDEN, ARIES D (NP)
Entity type:Individual
Prefix:
First Name:ARIES
Middle Name:D
Last Name:LOWDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ARIES
Other - Middle Name:D
Other - Last Name:WILFONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-777-6435
Mailing Address - Fax:317-777-6644
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:ROC 4270
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-278-7738
Practice Address - Fax:317-274-7227
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001883363LP0200X
IN28144663363LP0200X
IN71001883A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200509920Medicaid
Q40833Medicare UPIN
IN145590L8Medicare PIN