Provider Demographics
NPI:1346474483
Name:HOWE, TRACI WATSON (APN)
Entity Type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:WATSON
Last Name:HOWE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11215 HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3809
Mailing Address - Country:US
Mailing Address - Phone:501-379-9054
Mailing Address - Fax:501-379-9154
Practice Address - Street 1:11215 HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3809
Practice Address - Country:US
Practice Address - Phone:501-379-9054
Practice Address - Fax:501-379-9154
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily