Provider Demographics
NPI:1366670309
Name:LOWERY, CARMISHIA N (PA)
Entity type:Individual
Prefix:
First Name:CARMISHIA
Middle Name:N
Last Name:LOWERY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 WESLEY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6426
Practice Address - Country:US
Practice Address - Phone:901-516-5741
Practice Address - Fax:901-516-5986
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL085003475363AM0700X
MSPA00601363AM0700X
TN2745363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1316221294OtherMEDICARE