Healthcare Provider Details

I. General information

NPI: 1801957105
Provider Name (Legal Business Name): MYRA T HOWARD R.N-C,F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 05/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 W HIGHWAY 246
BUELLTON CA
93427-9459
US

IV. Provider business mailing address

195 W HIGHWAY 246
BUELLTON CA
93427-9459
US

V. Phone/Fax

Practice location:
  • Phone: 805-686-8555
  • Fax: 805-686-8556
Mailing address:
  • Phone: 805-686-8555
  • Fax: 805-686-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN306265
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: