Healthcare Provider Details

I. General information

NPI: 1164267266
Provider Name (Legal Business Name): MRS. ANDREA HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W LOMBARD ST
BALTIMORE MD
21201-1512
US

IV. Provider business mailing address

655 W LOMBARD ST
BALTIMORE MD
21201-1512
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-4359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number159898
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: