Provider Demographics
NPI:1366785677
Name:HOWELL, DANIELLE JAWORSKI (NP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:JAWORSKI
Last Name:HOWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 978
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-388-0115
Mailing Address - Fax:901-385-7924
Practice Address - Street 1:2961 CANADA RD
Practice Address - Street 2:SUITE 105
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-4893
Practice Address - Country:US
Practice Address - Phone:901-388-0115
Practice Address - Fax:901-385-7924
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN17293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I506016Medicare PIN