Provider Demographics
NPI:1598190829
Name:HOWELL, LISA ANN (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
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 1:495 BLUE DRAGONFLY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-9124
Mailing Address - Country:US
Mailing Address - Phone:843-437-7915
Mailing Address - Fax:
Practice Address - Street 1:495 BLUE DRAGONFLY DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-9124
Practice Address - Country:US
Practice Address - Phone:843-437-7915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC66158163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse