Provider Demographics
NPI:1225292204
Name:HOWELL, HOLLY (FNP-C)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 TRUMAN RD
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036-4644
Mailing Address - Country:US
Mailing Address - Phone:478-783-4190
Mailing Address - Fax:478-892-8055
Practice Address - Street 1:42 TRUMAN RD
Practice Address - Street 2:
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036-4644
Practice Address - Country:US
Practice Address - Phone:478-783-4190
Practice Address - Fax:478-892-8055
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN112484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily