=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801261110
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WHITNEY HOWELL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2015
-----------------------------------------------------
Last Update Date | 12/11/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13335 W MISSOURI AVE
-----------------------------------------------------
City | LITCHFIELD PARK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85340-8500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-547-1218
-----------------------------------------------------
Fax | 624-547-4770
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13335 W MISSOURI AVE
-----------------------------------------------------
City | LITCHFIELD PARK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85340-8500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-547-1218
-----------------------------------------------------
Fax | 623-547-4770
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | LP046151
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------