Provider Demographics
NPI:1750134763
Name:VENABLE, HOWARD K
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:K
Last Name:VENABLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4894 DIPPEN RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-9711
Mailing Address - Country:US
Mailing Address - Phone:336-779-0016
Mailing Address - Fax:
Practice Address - Street 1:4894 DIPPEN RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-9711
Practice Address - Country:US
Practice Address - Phone:336-779-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No171WV0202XOther Service ProvidersContractorVehicle Modifications
No372600000XNursing Service Related ProvidersAdult Companion