Individual
ETHAN MICHAEL CLARK HOWE
Active
Individual
ETHAN MICHAEL CLARK HOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
39220
MT
363LA2200X
Adult Health Nurse Practitioner
SP010207
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023796170001
—
PA
01
—
2125687
BLUE SHIELD HIGH MARK
PA
Enumeration date
04/23/2009
Last updated
04/22/2010
Update your record
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