Basic Information
| Provider Information | |||||||||
| NPI: | 1699752949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOWELL | ||||||||
| FirstName: | KRYSTIN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61 WHITCHER ST NE | ||||||||
| Address2: | SUITE 3100 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300601142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704290031 | ||||||||
| FaxNumber: | 6788194299 | ||||||||
| Practice Location | |||||||||
| Address1: | 61 WHITCHER ST NE | ||||||||
| Address2: | SUITE 3100 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300601142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704290031 | ||||||||
| FaxNumber: | 6788194299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN148919 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.