Provider Demographics
NPI:1154662344
Name:HOWELL, DEIDRE B (RN)
Entity Type:Individual
Prefix:
First Name:DEIDRE
Middle Name:B
Last Name:HOWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 S MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-5890
Mailing Address - Country:US
Mailing Address - Phone:706-212-0289
Mailing Address - Fax:706-212-0296
Practice Address - Street 1:184 S MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-5890
Practice Address - Country:US
Practice Address - Phone:706-212-0289
Practice Address - Fax:706-212-0296
Is Sole Proprietor?:No
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN118964163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health