Provider Demographics
NPI:1225896947
Name:HOWLETT, MARVALYN R
Entity Type:Individual
Prefix:MISS
First Name:MARVALYN
Middle Name:R
Last Name:HOWLETT
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 1:71 BIRDSEY ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-2508
Mailing Address - Country:US
Mailing Address - Phone:203-343-4833
Mailing Address - Fax:860-955-1424
Practice Address - Street 1:71 BIRDSEY ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2508
Practice Address - Country:US
Practice Address - Phone:103-243-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTNA6702269376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty