Healthcare Provider Details

I. General information

NPI: 1306018478
Provider Name (Legal Business Name): WILLA SUE HOWERTON A.P.N
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2008
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N GARLAND AVE 1 UNIVERSITY OF ARKANSAS
FAYETTEVILLE AR
72701-3110
US

IV. Provider business mailing address

525 NORTH GARLAND AVENUE 1 UNIVERSITY OF ARKANSAS
FAYETTEVILLE AR
72701
US

V. Phone/Fax

Practice location:
  • Phone: 479-575-4451
  • Fax:
Mailing address:
  • Phone: 479-575-4451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA03094 ANP
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: