Provider Demographics
NPI:1760160485
Name:HOWELL, KILEY ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:ANN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KILEY
Other - Middle Name:ANN
Other - Last Name:MICETICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:920 N QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-3866
Mailing Address - Country:US
Mailing Address - Phone:641-455-5200
Mailing Address - Fax:
Practice Address - Street 1:920 N QUINCY AVE
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-3866
Practice Address - Country:US
Practice Address - Phone:641-455-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA172709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily