Individual
TARA LOWRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
9 MEDICAL PARK RD, SUITE 320, COLUMBIA, SC 29203
(803) 434-7151
Mailing address
5 MEDICAL PARK RD, NICU, COLUMBIA, SC 29203
(803) 343-7000
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
19648
SC
363LN0005X
Critical Care Neonatal Nurse Practitioner
19648
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3468
—
SC
Enumeration date
08/12/2015
Last updated
02/26/2021
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