Provider Demographics
NPI:1104941871
Name:HOWELL, STEPHANIE LYNN
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:HOWELL
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:HC 80 BOX 8330
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:KY
Mailing Address - Zip Code:41141
Mailing Address - Country:US
Mailing Address - Phone:606-757-2343
Mailing Address - Fax:606-757-2343
Practice Address - Street 1:108 GLOVER ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662
Practice Address - Country:US
Practice Address - Phone:740-353-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2308783Medicaid