Individual
TEIRRAHA CHANNEL LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
113 SCENIC OUTLET LN STE 2, MOUNT AIRY, NC 27030-9978
(336) 352-4900
(336) 352-4901
Mailing address
113 SCENIC OUTLET LN STE 2, MOUNT AIRY, NC 27030-9978
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
5012909
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
5012909
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5012909
NCBON
NC
Enumeration date
02/25/2020
Last updated
06/22/2020
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