1386813632 NPI number — MRS. MARY ANN HOWELL ANP-BC

Table of content: MRS. MARY ANN HOWELL ANP-BC (NPI 1386813632)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386813632 NPI number — MRS. MARY ANN HOWELL ANP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWELL
Provider First Name:
MARY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ANP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAHLMUS
Provider Other First Name:
MARY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386813632
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2340 N HILLS ST
Provider Second Line Business Mailing Address:
STE F
Provider Business Mailing Address City Name:
MERIDIAN
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39305-2651
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-581-7600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2340 N HILLS ST
Provider Second Line Business Practice Location Address:
STE F
Provider Business Practice Location Address City Name:
MERIDIAN
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39305-2651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-282-3354
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  R872969 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05202503 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01033053 . This is a "MS RAILROAD" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".




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