Provider Demographics
NPI:1972583268
Name:HOWARD, GARRILYN (LPN)
Entity type:Individual
Prefix:MRS
First Name:GARRILYN
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8853 N KRAFT RD
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-7002
Mailing Address - Country:US
Mailing Address - Phone:208-234-3656
Mailing Address - Fax:
Practice Address - Street 1:120 S RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-3205
Practice Address - Country:US
Practice Address - Phone:208-236-5218
Practice Address - Fax:208-236-5201
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPN-8065164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse