Provider Demographics
NPI:1841738275
Name:HOWARD, CHRISTY MICHELLE (CPNP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:MICHELLE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY TOP
Mailing Address - State:TN
Mailing Address - Zip Code:37769-3029
Mailing Address - Country:US
Mailing Address - Phone:865-223-4058
Mailing Address - Fax:
Practice Address - Street 1:1046 DIVISION ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-2935
Practice Address - Country:US
Practice Address - Phone:228-374-2494
Practice Address - Fax:228-396-3457
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904333363LP0200X, 363L00000X
TN22204363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics