Individual
MRS. TIFFANY LYNN LOWERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1513 E PRESIDIO ST, FORT WORTH, TX 76102-6735
(817) 702-1100
(817) 702-2939
Mailing address
2903 CRYSTAL WAY, GRAND PRAIRIE, TX 75052
(662) 549-4999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1011090
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
1011090
TX
363LG0600X
Gerontology Nurse Practitioner
1011090
TX
Other
Enumeration date
09/06/2020
Last updated
03/29/2022
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