Provider Demographics
NPI:1861782062
Name:LOWE, STACY DUNNE (PA)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:DUNNE
Last Name:LOWE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:STACY
Other - Middle Name:MARIE
Other - Last Name:DUNNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:6306 XAVIER ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-6631
Mailing Address - Country:US
Mailing Address - Phone:704-451-0002
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST # MC0188
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004633RX363A00000X
NC001002754363A00000X
COPA.0005299363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant