Provider Demographics
NPI:1992116511
Name:HOWZE, DEREK (BBA)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:HOWZE
Suffix:
Gender:M
Credentials:BBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 PROSPECT AVE E APT 1025
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-1239
Mailing Address - Country:US
Mailing Address - Phone:216-233-9859
Mailing Address - Fax:
Practice Address - Street 1:1012 PROSPECT AVE E APT 1025
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-1239
Practice Address - Country:US
Practice Address - Phone:216-233-9859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide