Provider Demographics
NPI:1144947854
Name:LOWE, JERRICA (FNP-BC)
Entity type:Individual
Prefix:
First Name:JERRICA
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4485 HIGHWAY 92
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37861-4665
Mailing Address - Country:US
Mailing Address - Phone:865-335-2847
Mailing Address - Fax:
Practice Address - Street 1:420 W MORRIS BLVD STE 130
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2255
Practice Address - Country:US
Practice Address - Phone:423-581-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2017023384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily