Provider Demographics
NPI:1063492619
Name:HOWELL, JEANNE M (CNM)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:HOWELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2537
Mailing Address - Country:US
Mailing Address - Phone:320-762-0399
Mailing Address - Fax:320-762-6847
Practice Address - Street 1:1527 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2537
Practice Address - Country:US
Practice Address - Phone:320-762-0399
Practice Address - Fax:320-762-6847
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0591360367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN249040400Medicaid
MN121951D277OtherUCARE
MN1001424OtherPREFERRED ONE
MN31T09HOOtherBLUE SHIELD
MN763968OtherAMERICA'S PPO
MN0702872OtherMEDICA
MNA011OtherCHAMPUS
MNHP24910OtherHEALTH PARTNERS
MN121951D277OtherUCARE
MN249040400Medicaid
MN420001186Medicare PIN