Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 4704318357 | MI |
NPI | 1073194155 |
---|---|
Provider Name | Celene Howard |
First Address | Fenton, MI 48430-8743 |
Second Address | Flint, MI 48503-5902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2021 |
Last Update Date | 26/04/2021 |