Provider Demographics
NPI:1801903380
Name:HOWARD, TRICIA DIANE (PA)
Entity type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:DIANE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:TRICIA
Other - Middle Name:DIANE
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-7644
Mailing Address - Country:US
Mailing Address - Phone:912-756-2273
Mailing Address - Fax:912-756-3773
Practice Address - Street 1:60 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-7644
Practice Address - Country:US
Practice Address - Phone:912-756-2273
Practice Address - Fax:912-756-3773
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004085363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical