Individual
DIANA LYNN LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2538
Mailing address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9541
(309) 692-5393
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209010028
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305582703
ILLINOIS MEDICAID
IL
Enumeration date
03/26/2007
Last updated
03/05/2013
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