Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | RN174263 | GA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN174263 | GA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN174263 | GA |
NPI | 1063952471 |
---|---|
Provider Name | Michelle Howard |
First Address | Macon, GA 31217-3805 |
Second Address | Macon, GA 31217-3805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2017 |
Last Update Date | 03/03/2017 |