Provider Demographics
NPI:1376056697
Name:HOWARD, KATHRYN RAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:RAE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:RAE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 ELEVENTH STREET
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241
Mailing Address - Country:US
Mailing Address - Phone:304-636-9150
Mailing Address - Fax:304-636-9157
Practice Address - Street 1:40 ELEVENTH STREET
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241
Practice Address - Country:US
Practice Address - Phone:304-636-9150
Practice Address - Fax:304-636-9157
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV94495163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse