Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 0104001609 | VA |
N | 111NN1001X | Nutrition | DC007673L | PA |
N | 111NN1001X | Nutrition | X008367-1 | NY |
N | 111NT0100X | Thermography | 0104001609 | VA |
Y | 111NT0100X | Thermography | DC007673L | PA |
N | 111NT0100X | Thermography | X008367-1 | NY |
NPI | 1598894867 |
---|---|
Provider Name | Pamela J Howard |
First Address | Gardners, PA 17324-9614 |
Second Address | Mechanicsburg, PA 17055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 09/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02634500 | CAPITAL BLUECROSS (01) | PA |
HO178084 | PA BLUE SHIELD (01) | PA |
U83270 | (02) | NY |