Provider Demographics
NPI:1922538081
Name:HOWELL, TAMARA DAWN (LPN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:DAWN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 S MOODY DR
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:OK
Mailing Address - Zip Code:73098-1210
Mailing Address - Country:US
Mailing Address - Phone:405-331-9603
Mailing Address - Fax:
Practice Address - Street 1:1904 W BROADWAY AVE STE 1
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:OK
Practice Address - Zip Code:73086-4248
Practice Address - Country:US
Practice Address - Phone:580-622-6134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60772164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse