Provider Demographics
NPI:1093968182
Name:HOWARD, GAYNELLE PETRICE
Entity Type:Individual
Prefix:MISS
First Name:GAYNELLE
Middle Name:PETRICE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20081 WALTER HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7211
Mailing Address - Country:US
Mailing Address - Phone:980-205-2204
Mailing Address - Fax:
Practice Address - Street 1:20081 WALTER HENDERSON RD
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-7211
Practice Address - Country:US
Practice Address - Phone:980-205-2204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter