Provider Demographics
NPI:1902310931
Name:HOWARD, HEATHER NICHOLE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICHOLE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DOROTHY FORD LN SW APT 231
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-7519
Mailing Address - Country:US
Mailing Address - Phone:256-431-2373
Mailing Address - Fax:
Practice Address - Street 1:101 IVORY PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2349
Practice Address - Country:US
Practice Address - Phone:256-417-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-143484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily