Provider Demographics
NPI:1790546810
Name:HOWARD, TOMIA T (CERTIFIED NURSING AS)
Entity Type:Individual
Prefix:
First Name:TOMIA
Middle Name:T
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CERTIFIED NURSING AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 GILMORE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-5516
Mailing Address - Country:US
Mailing Address - Phone:352-792-7258
Mailing Address - Fax:
Practice Address - Street 1:3149 GILMORE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-5516
Practice Address - Country:US
Practice Address - Phone:352-792-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA405638251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health