| Doctor Name: | DAN POWELL |
| NPI Number: | 1073917654 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BSN, RN |
| License Number: | 144548-30 |
| Business Practice Address: | 2500 Hall Ave Suitei B Marinette, WI - 541431655 |
| Business Phone Number: | 7157327589 |
| Business Fax Number: | 7157327766 |
| Mailing Address: | 2500 Hall Ave, Suitei B MARINETTE |
| State: | WI |
| Postal Code: | 541431655 |
| Phone Number: | 7157327589 |
| Fax Number: | 7157327766 |
| NPI Enumeration Date: | 10/10/2014 |
| NPI Last Update Date: | 10/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 144548-30 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |