Jacklyn Lowry, LPN
Individual provider Active NPI Licensed Practical Nurse · Park Hills, MO
NPI 1487023446 · NPPES record last updated Sep 21, 2015
Key facts
- NPI
- 1487023446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 2007028314 (MO)
- Practice address
- 512 E Main St
Park Hills, MO 63601-2624 - Phone
- (573) 431-0554
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007028314 | MO | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Missouri Behavioral Health Inc | Past | Accepting new patients | |
| Southeast Missouri Behavioral Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 2007028314 | MO | Yes |
Addresses
Primary practice location
512 E Main St
Park Hills, MO 63601-2624
Mailing address
PO Box 459
Farmington, MO 63640-0459
Other providers in Park Hills, MO
- Lbenholdings
- Christin Lewis
- Lisa Michelle Long
- Tonya Monique Long
- Carrie Lorentz
- Walter Major
- Susan McCarron
- MCD Care, LLC
- Ashley Brooke McFarland
- Robene McKoy
All providers in Park Hills, MO · Licensed Practical Nurse in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.