Provider Demographics
NPI:1255531315
Name:HOWARD, SHONTAE LANELLE (FNP)
Entity type:Individual
Prefix:
First Name:SHONTAE
Middle Name:LANELLE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WEST WENGER RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 W WENGER RD STE J
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2755
Practice Address - Country:US
Practice Address - Phone:937-529-8085
Practice Address - Fax:855-299-2185
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 347020163W00000X
OHAPRN.CNP.023231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse