Provider Demographics
NPI:1346274784
Name:HOWARD, PAULA (NP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 ROBERTSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3900
Mailing Address - Country:US
Mailing Address - Phone:970-224-1596
Mailing Address - Fax:970-530-1919
Practice Address - Street 1:1006 ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3900
Practice Address - Country:US
Practice Address - Phone:970-224-1596
Practice Address - Fax:970-530-1919
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51444363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00294822OtherRR MEDICARE
CO71384545Medicaid
CO80627544Medicaid
CODB5993OtherGROUP RR MEDICARE
COP00294822OtherRR MEDICARE
CO435708Medicare ID - Type UnspecifiedGROUP
CO80627544Medicaid