Provider Demographics
NPI:1407382021
Name:HOWARD, TRACI BOWERS (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:BOWERS
Last Name:HOWARD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 DUWARD ST
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:GA
Mailing Address - Zip Code:31557-2461
Mailing Address - Country:US
Mailing Address - Phone:912-282-1597
Mailing Address - Fax:912-490-4674
Practice Address - Street 1:505 CITY BLVD
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-8003
Practice Address - Country:US
Practice Address - Phone:912-490-2229
Practice Address - Fax:912-490-9023
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203147363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily