Provider Demographics
NPI:1710153614
Name:HOWENSTINE, LYDIA L (RN)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:L
Last Name:HOWENSTINE
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 1:173 SYCAMORE DR NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-5336
Mailing Address - Country:US
Mailing Address - Phone:330-244-1822
Mailing Address - Fax:
Practice Address - Street 1:173 SYCAMORE DR NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-5336
Practice Address - Country:US
Practice Address - Phone:330-244-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH292549163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2641332Medicaid