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General NPI Number Information
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NPI Number | 1003685934
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Entity Type | Organization
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Legal Business Name | SHONTAE L HOWARD
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 12 W WENGER RD STE J
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City | ENGLEWOOD
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State | OH
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Zip | 45322-2755
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Country | US
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Telephone | 937-529-8085
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Fax |
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Provider Business Mailing Address
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Address Line | 12 W WENGER RD STE J
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City | ENGLEWOOD
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State | OH
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Zip | 45322-2755
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Country | US
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Telephone | 937-529-8085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHONTAE HOWARD
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Credential |
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Telephone | 937-529-8085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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