Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 209015725 | IL |
NPI | 1366979437 |
---|---|
Provider Name | Michelle Dawn Howland |
First Address | Peoria, IL 61637-0001 |
Second Address | Peoria, IL 61637-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2017 |
Last Update Date | 06/07/2021 |