Individual
JORDAN LARA LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4800 FRIENDSHIP AVE, 3RD FLOOR, PITTSBURGH, PA 15224-1722
(412) 578-5858
(412) 578-1529
Mailing address
4800 FRIENDSHIP AVE, 3RD FLOOR, PITTSBURGH, PA 15224-1722
(412) 578-5858
(412) 578-1529
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1110636
NCCPA CERTIFICATION
—
01
—
MA056245
STATE LISC
PA
01
—
MX021283
WRITTEN AGREEMENT
PA
Enumeration date
07/17/2013
Last updated
10/18/2023
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