Provider Demographics
NPI:1326077934
Name:HOWARD, DNELL B (FNP-C)
Entity Type:Individual
Prefix:
First Name:DNELL
Middle Name:B
Last Name:HOWARD
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 1:4088 N HIGHWAY 91
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84318-4125
Mailing Address - Country:US
Mailing Address - Phone:435-563-4900
Mailing Address - Fax:435-563-4951
Practice Address - Street 1:4088 N HIGHWAY 91
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:UT
Practice Address - Zip Code:84318-4125
Practice Address - Country:US
Practice Address - Phone:435-563-4900
Practice Address - Fax:435-563-4951
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2146514405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTS53982Medicare UPIN
UT05738703Medicare ID - Type Unspecified