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Individual
MARY WALLACE HOWELL
Active
Individual
MARY WALLACE HOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC FNP
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14001
CA
363L00000X
Nurse Practitioner
NP8902
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA14001
MEDI-CAL
CA
Enumeration date
06/07/2006
Last updated
06/28/2018
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