Doctor Name: | ROBERT POWELL |
NPI Number: | 1104824382 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CNP |
License Number: | 0024166051 |
Business Practice Address: | 514 W Atlantic St South Hill, VA - 239701906 |
Business Phone Number: | 4344476969 |
Business Fax Number: | 4344472240 |
Mailing Address: | 514 W Atlantic St, SOUTH HILL |
State: | VA |
Postal Code: | 239701906 |
Phone Number: | 4344476969 |
Fax Number: | 4344472240 |
NPI Enumeration Date: | 07/12/2005 |
NPI Last Update Date: | 03/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0024166051 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |