Provider Demographics
NPI:1023509726
Name:LOWE, TIFFANY MARSHAWN (MSN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:MARSHAWN
Last Name:LOWE
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1603
Mailing Address - Country:US
Mailing Address - Phone:404-761-4040
Mailing Address - Fax:
Practice Address - Street 1:535 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1603
Practice Address - Country:US
Practice Address - Phone:404-761-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN181023363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN181023OtherGEORGIA BOARD OF NURSING
F03180182OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS