Provider Demographics
NPI:1891207379
Name:HOWELL, AMY ELLEN JEAN (NP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELLEN JEAN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1174 W MICHIGAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1625
Mailing Address - Country:US
Mailing Address - Phone:269-789-4390
Mailing Address - Fax:
Practice Address - Street 1:1174 W MICHIGAN AVE STE B
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1625
Practice Address - Country:US
Practice Address - Phone:269-789-4390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704274965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily