Provider Demographics
NPI:1831230564
Name:HOWELL, DELCORA (ARNP)
Entity type:Individual
Prefix:MS
First Name:DELCORA
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:DELCORA
Other - Middle Name:
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:1745 STATE ROAD 100
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:FL
Mailing Address - Zip Code:32666-3146
Mailing Address - Country:US
Mailing Address - Phone:352-478-2471
Mailing Address - Fax:352-478-2496
Practice Address - Street 1:1745 STATE ROAD 100
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:FL
Practice Address - Zip Code:32666-3146
Practice Address - Country:US
Practice Address - Phone:352-478-2471
Practice Address - Fax:352-478-2496
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 780412363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3014690Medicaid
ARNP780412OtherLICENSE