Provider Demographics
NPI:1306910153
Name:LOWREY, JUDD A (DC, FNP-C)
Entity type:Individual
Prefix:
First Name:JUDD
Middle Name:A
Last Name:LOWREY
Suffix:
Gender:M
Credentials:DC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 GOLDEN FOOTHILL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762
Mailing Address - Country:US
Mailing Address - Phone:916-941-7508
Mailing Address - Fax:916-941-7482
Practice Address - Street 1:4909 GOLDEN FOOTHILL PARKWAY
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762
Practice Address - Country:US
Practice Address - Phone:916-941-7508
Practice Address - Fax:916-941-7482
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005728363LF0000X
CADC27259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0272590Medicare ID - Type UnspecifiedMEDICARE NUMBER