Provider Demographics
NPI:1194212738
Name:HOWARD, JUDY FERN (LVN)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:FERN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-2539
Mailing Address - Country:US
Mailing Address - Phone:325-733-4249
Mailing Address - Fax:
Practice Address - Street 1:1112 E 12TH ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-2539
Practice Address - Country:US
Practice Address - Phone:325-733-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX145195164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse