=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306018478
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLA SUE HOWERTON A.P.N
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2008
-----------------------------------------------------
Last Update Date | 12/06/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 525 N GARLAND AVE 1 UNIVERSITY OF ARKANSAS
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72701-3110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-575-4451
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 525 NORTH GARLAND AVENUE 1 UNIVERSITY OF ARKANSAS
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-575-4451
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | A03094 ANP
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------