Provider Demographics
NPI:1407079684
Name:HOWELL, PENNY (RN)
Entity Type:Individual
Prefix:MS
First Name:PENNY
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 ALGOMA BLVD
Mailing Address - Street 2:RADFORD HALL
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-3534
Mailing Address - Country:US
Mailing Address - Phone:920-424-2424
Mailing Address - Fax:920-424-1769
Practice Address - Street 1:777 ALGOMA BLVD
Practice Address - Street 2:RADFORD HALL
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-3534
Practice Address - Country:US
Practice Address - Phone:920-424-2424
Practice Address - Fax:920-424-1769
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI70498030163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health