Provider Demographics
NPI:1386813632
Name:HOWELL, MARY ANN (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:KAHLMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2340 N HILLS ST
Mailing Address - Street 2:STE F
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-2651
Mailing Address - Country:US
Mailing Address - Phone:601-581-7600
Mailing Address - Fax:
Practice Address - Street 1:2340 N HILLS ST
Practice Address - Street 2:STE F
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-2651
Practice Address - Country:US
Practice Address - Phone:601-282-3354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR872969363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05202503Medicaid
MSP01033053OtherMS RAILROAD
MS05202503Medicaid