1033507660 NPI number — MS. KIMBERLY LOUISE HOWARD RPTA

Table of content: MS. KIMBERLY LOUISE HOWARD RPTA (NPI 1033507660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033507660 NPI number — MS. KIMBERLY LOUISE HOWARD RPTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWARD
Provider First Name:
KIMBERLY
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RPTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORGAN
Provider Other First Name:
KIMBERLY
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPTA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1033507660
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4408
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74159
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-272-1039
Provider Business Mailing Address Fax Number:
918-272-7159

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12899 EAST 76TH ST NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWASSO
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-272-1039
Provider Business Practice Location Address Fax Number:
918-272-7159
Provider Enumeration Date:
01/06/2015

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: 225200000X , with the licence number:  1377 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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