Provider Demographics
NPI:1902052814
Name:LOWRY, MARY ELLEN (CNM)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELLEN
Last Name:LOWRY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LOWRY
Other - Last Name:SILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 E CARVER ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2133
Mailing Address - Country:US
Mailing Address - Phone:919-471-2273
Mailing Address - Fax:
Practice Address - Street 1:209 E CARVER ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2133
Practice Address - Country:US
Practice Address - Phone:919-471-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC308367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife