Provider Demographics
NPI:1538686191
Name:HOWARD, GIOVANNI NICOSHA (LPN)
Entity Type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:NICOSHA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2030
Mailing Address - Country:US
Mailing Address - Phone:216-308-5001
Mailing Address - Fax:
Practice Address - Street 1:17814 DELAVAN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-3149
Practice Address - Country:US
Practice Address - Phone:205-520-5582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH163494164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse