Provider Demographics
NPI:1285937284
Name:HOWELL, DERRICE ANDREA (NP)
Entity type:Individual
Prefix:MRS
First Name:DERRICE
Middle Name:ANDREA
Last Name:HOWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 GARDENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1150
Mailing Address - Country:US
Mailing Address - Phone:716-877-0076
Mailing Address - Fax:
Practice Address - Street 1:124 GARDENWOOD LN
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223-1150
Practice Address - Country:US
Practice Address - Phone:716-877-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340759-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology