Provider Demographics
NPI:1750588349
Name:HOWARD, KELLY THOMPSON (RN, MSN)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:THOMPSON
Last Name:HOWARD
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7305 59TH PL NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-8888
Mailing Address - Country:US
Mailing Address - Phone:425-512-2177
Mailing Address - Fax:
Practice Address - Street 1:7305 59TH PL NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-8888
Practice Address - Country:US
Practice Address - Phone:425-512-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00141002163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse