Provider Demographics
NPI:1427078161
Name:LOWE, JUDY LYNN (PA)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:LYNN
Last Name:LOWE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 AIRPORT WAY STE 130B
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4056
Mailing Address - Country:US
Mailing Address - Phone:907-452-2178
Mailing Address - Fax:907-452-3524
Practice Address - Street 1:1867 AIRPORT WAY STE 130B
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4056
Practice Address - Country:US
Practice Address - Phone:907-452-2178
Practice Address - Fax:907-452-3524
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK377363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK151690Medicare ID - Type Unspecified
AKP31123Medicare UPIN