1700394541 NPI number — OLIVIA P. HOWARD RPH, PHARMD, BCPS

Table of content: DR. KIRK A SUDEALL (NPI 1770636011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700394541 NPI number — OLIVIA P. HOWARD RPH, PHARMD, BCPS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWARD
Provider First Name:
OLIVIA
Provider Middle Name:
P.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPH, PHARMD, BCPS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700394541
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3510 HILLSBORO PIKE APT 84
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37215-1431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-735-2541
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1310 24TH AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37212-2637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-327-4751
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/15/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P2201X , with the licence number:  020703 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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