Provider Demographics
NPI:1952458432
Name:HOWELL, JUDY (NP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6278
Mailing Address - Country:US
Mailing Address - Phone:978-521-3288
Mailing Address - Fax:978-469-5644
Practice Address - Street 1:1 PARK WAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6278
Practice Address - Country:US
Practice Address - Phone:978-521-3288
Practice Address - Fax:978-469-5644
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA161171363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP5615OtherBLUE CROSS BLUE SHIELD
MANP5615OtherBLUE CROSS BLUE SHIELD
MANP5615Medicare PIN