Basic Information
Provider Information
NPI: 1417495300
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOWRANCE
FirstName: STEPHANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APN
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 520 S 7TH ST
Address2:  
City: VINCENNES
State: IN
PostalCode: 475911038
CountryCode: US
TelephoneNumber: 8128825220
FaxNumber:  
Practice Location
Address1: 721 E COURT ST
Address2:  
City: PARIS
State: IL
PostalCode: 619442460
CountryCode: US
TelephoneNumber: 2174654141
FaxNumber: 2174655615
Other Information
ProviderEnumerationDate: 02/10/2017
LastUpdateDate: 12/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X209015605ILN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000X71007115AINN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X209015605ILY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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