Provider Demographics
NPI:1851370993
Name:HOWELL, RODNEY CLIFFORD (ARNP)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:CLIFFORD
Last Name:HOWELL
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 W 6TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:COAL VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61240-9160
Mailing Address - Country:US
Mailing Address - Phone:309-737-5826
Mailing Address - Fax:
Practice Address - Street 1:308 W 6TH AVENUE CT
Practice Address - Street 2:
Practice Address - City:COAL VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61240-9160
Practice Address - Country:US
Practice Address - Phone:309-737-5826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005693363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08132169OtherB/S PROVIDER
IL209-005693OtherLICENSE #
IL08132169OtherB/S PROVIDER
IL$$$$$$$$$001Medicaid