Individual
VIVIAN JILL LOWERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2511 OLD CORNWALLIS RD STE 200, DURHAM, NC 27713
(844) 932-5700
Mailing address
2511 OLD CORNWALLIS RD STE 200, DURHAM, NC 27713-1869
(844) 932-5700
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
5000964
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4181
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5000964
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6113007
—
NC
Enumeration date
08/17/2005
Last updated
11/15/2019
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