Provider Demographics
NPI:1750764387
Name:HOWELL, JENNIFER LYNN (RT (R))
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:RT (R)
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:CARLISLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5901 BROKEN SOUND PARKWAY #450
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2787
Mailing Address - Country:US
Mailing Address - Phone:888-367-2616
Mailing Address - Fax:844-263-6823
Practice Address - Street 1:5901 BROKEN SOUND PARKWAY #450
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2787
Practice Address - Country:US
Practice Address - Phone:888-367-2616
Practice Address - Fax:844-263-6823
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL362625247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist