Provider Demographics
NPI:1114723996
Name:LOWRY, MELISSA (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:LOWRY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18231 KEOKUK ST
Mailing Address - Street 2:
Mailing Address - City:ACKWORTH
Mailing Address - State:IA
Mailing Address - Zip Code:50001-5643
Mailing Address - Country:US
Mailing Address - Phone:856-839-8902
Mailing Address - Fax:
Practice Address - Street 1:18231 KEOKUK ST
Practice Address - Street 2:
Practice Address - City:ACKWORTH
Practice Address - State:IA
Practice Address - Zip Code:50001-5643
Practice Address - Country:US
Practice Address - Phone:856-839-8902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA180215163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse