Provider Demographics
NPI:1871536839
Name:HOWARD, RAYMOND C (NP)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:C
Last Name:HOWARD
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6170 SHALLOWFORD RD
Mailing Address - Street 2:101
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1892
Mailing Address - Country:US
Mailing Address - Phone:423-648-4500
Mailing Address - Fax:423-855-7563
Practice Address - Street 1:4490 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-5038
Practice Address - Country:US
Practice Address - Phone:423-875-0700
Practice Address - Fax:423-875-3391
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN8089363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
3349684Medicare ID - Type Unspecified
TN33496841Medicare UPIN
TN1016710001Medicare NSC
P99412Medicare UPIN