Basic Information
| Provider Information | |||||||||
| NPI: | 1982320875 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | ALLIE | ||||||||
| MiddleName: | LORRAINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 607 TRAFALGAR LN | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309093331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068292562 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1446 HARPER ST | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067212273 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2022 | ||||||||
| LastUpdateDate: | 10/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN236050 | GA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.