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NPI Code Detail

MEDICARE: IVY HOWARD

MEDICARE: IVY HOWARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1316879711
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVY HOWARD
Provider Business Mailing Address
First Line : 102 S WINOOSKI AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-7406
Country : US
Telephone Number : 802-488-6920
Fax Number : 802-488-6919
Provider Business Practice Location Address
First Line : 102 S WINOOSKI AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-7406
Country : US
Telephone Number : 802-488-6000
Fax Number : 802-488-6919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Practice Location Address:
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Directions to “ IVY HOWARD ” Practice Location

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