1659326734 NPI number — LYNDA DARLENE HOWL RNC WHCNP

Table of content: LYNDA DARLENE HOWL RNC WHCNP (NPI 1659326734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659326734 NPI number — LYNDA DARLENE HOWL RNC WHCNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWL
Provider First Name:
LYNDA
Provider Middle Name:
DARLENE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RNC WHCNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRANTLEY
Provider Other First Name:
LYNDA
Provider Other Middle Name:
DARLENE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RNC WHCNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659326734
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
607 LINCOLN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76006-3648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-832-1880
Provider Business Mailing Address Fax Number:
817-832-1880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
122 W COLORADO BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75208-2382
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-947-6700
Provider Business Practice Location Address Fax Number:
214-947-6701
Provider Enumeration Date:
05/24/2006

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: 363LW0102X , with the licence number:  638529 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1612707 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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