Provider Demographics
NPI:1174869408
Name:LOWRANCE, DEBRA B (CNM, IBCLC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:B
Last Name:LOWRANCE
Suffix:
Gender:F
Credentials:CNM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12188 N 920TH ST
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:IL
Mailing Address - Zip Code:62454-4314
Mailing Address - Country:US
Mailing Address - Phone:618-553-8369
Mailing Address - Fax:959-666-6204
Practice Address - Street 1:309 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:IL
Practice Address - Zip Code:62454-2722
Practice Address - Country:US
Practice Address - Phone:618-553-8369
Practice Address - Fax:959-666-6204
Is Sole Proprietor?:No
Enumeration Date:2012-12-13
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.010085367A00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife