Individual
NICOLE T LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9855 HOSPITAL DR, MAPLE GROVE, MN 55369-4648
(763) 581-9220
(763) 581-9221
Mailing address
9855 HOSPITAL DRIVE, MAPLE GROVE, MN 55369
(763) 581-9220
(763) 581-9221
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
BL6168442
IL
207Q00000X
Family Medicine Physician
Primary
036101859
IL
207Q00000X
Family Medicine Physician
54499
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100970
UNITED HEALTHCARE
—
05
—
036101859
—
IL
05
—
036101859-3
—
IL
01
—
080172806
RR MEDICARE
IL
05
—
1023014438
—
MO
01
—
38398
GROUP HEALTH PLAN
—
01
—
441397
HEALTHLINK
—
01
—
4622029
ADMINISTAR
IL
Enumeration date
06/22/2005
Last updated
08/30/2013
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