Basic Information
Provider Information
NPI: 1750616660
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOWETH
FirstName: DONYA
MiddleName: JENISE
NamePrefix: MS.
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 940-A HIGHWAY 96
Address2:  
City: WARNER ROBINS
State: GA
PostalCode: 31088
CountryCode: US
TelephoneNumber: 4789881222
FaxNumber: 4789881241
Practice Location
Address1: 940-A HIGHWAY 96
Address2:  
City: WARNER ROBINS
State: GA
PostalCode: 31088
CountryCode: US
TelephoneNumber: 4789881222
FaxNumber: 4789881241
Other Information
ProviderEnumerationDate: 10/09/2009
LastUpdateDate: 10/09/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XLPN078603GAY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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