Provider Demographics
NPI:1346713203
Name:HOWELL, JIMMY (NP-C)
Entity Type:Individual
Prefix:
First Name:JIMMY
Middle Name:
Last Name:HOWELL
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-6505
Mailing Address - Country:US
Mailing Address - Phone:229-425-9055
Mailing Address - Fax:
Practice Address - Street 1:116 BENJAMIN H HILL DR SW STE 12
Practice Address - Street 2:
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-9511
Practice Address - Country:US
Practice Address - Phone:229-424-7263
Practice Address - Fax:229-423-3601
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210349163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse