Provider Demographics
NPI:1437624392
Name:LOWRY, SHELLY DIONNE (RN)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:DIONNE
Last Name:LOWRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5713 BRENT DR
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76148-3704
Mailing Address - Country:US
Mailing Address - Phone:719-659-9306
Mailing Address - Fax:
Practice Address - Street 1:5713 BRENT DR
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76148-3704
Practice Address - Country:US
Practice Address - Phone:719-659-9306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX952745163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse