Healthcare Provider Details

I. General information

NPI: 1629933775
Provider Name (Legal Business Name): LILLIE HOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 UNION AVE STE 965
MEMPHIS TN
38104-6638
US

IV. Provider business mailing address

1211 UNION AVE STE 965
MEMPHIS TN
38104-6638
US

V. Phone/Fax

Practice location:
  • Phone: 901-478-0822
  • Fax:
Mailing address:
  • Phone: 901-478-0822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number208689
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: