Provider Demographics
NPI:1871515361
Name:LOWE, CATHERINE JOYCE (PA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JOYCE
Last Name:LOWE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1390
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MN
Mailing Address - Zip Code:56484-1390
Mailing Address - Country:US
Mailing Address - Phone:218-547-3938
Mailing Address - Fax:218-547-3922
Practice Address - Street 1:614 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MN
Practice Address - Zip Code:56484-1390
Practice Address - Country:US
Practice Address - Phone:218-547-3938
Practice Address - Fax:218-547-3922
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN9218363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S26734Medicare UPIN