Provider Demographics
NPI:1053387969
Name:HOWELL, WENDY OLIVER (CFNP)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:OLIVER
Last Name:HOWELL
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 448
Mailing Address - Street 2:2686 HWY 145 SOUTH STE B
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-0448
Mailing Address - Country:US
Mailing Address - Phone:662-869-8693
Mailing Address - Fax:662-869-0110
Practice Address - Street 1:2686 HIGHWAY 145
Practice Address - Street 2:SUITE B
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-6941
Practice Address - Country:US
Practice Address - Phone:662-869-8693
Practice Address - Fax:662-869-0110
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00125559Medicaid
MS06489045Medicaid
C02686Medicare PIN
MS258966Medicare ID - Type UnspecifiedRURAL HEALTH NUMBER
MS00125559Medicaid