Healthcare Provider Details

I. General information

NPI: 1881528412
Provider Name (Legal Business Name): JODY D HOWARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W LAS CRUCES AVE
LAS CRUCES NM
88005-2513
US

IV. Provider business mailing address

409 W LAS CRUCES AVE
LAS CRUCES NM
88005-2513
US

V. Phone/Fax

Practice location:
  • Phone: 575-642-5735
  • Fax:
Mailing address:
  • Phone: 575-642-5735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR51550
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: