Provider Demographics
NPI:1053723890
Name:HOWARD, CHRISTINA MECHELLE (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MECHELLE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MECHELLE
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 ADAMS LN STE 300
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-3088
Mailing Address - Country:US
Mailing Address - Phone:606-230-2255
Mailing Address - Fax:606-437-3001
Practice Address - Street 1:140 ADAMS LN STE 300
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3088
Practice Address - Country:US
Practice Address - Phone:606-230-2255
Practice Address - Fax:606-437-3001
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008642363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100302600Medicaid