Provider Demographics
NPI:1427208644
Name:HOWARD, KELLY DENISE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:DENISE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 FLORENCE BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2807
Mailing Address - Country:US
Mailing Address - Phone:256-448-9500
Mailing Address - Fax:256-448-9999
Practice Address - Street 1:2530 FLORENCE BLVD STE E
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2807
Practice Address - Country:US
Practice Address - Phone:256-448-9500
Practice Address - Fax:256-448-9999
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-099420363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL183248Medicaid
TNQ027813Medicaid