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NPI Code Detail

MEDICARE: MRS. LAURA HARRIS POWELL CRNP

MEDICARE: MRS. LAURA HARRIS POWELL CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse1-153398AL
2363LP2300XPrimary Care Nurse Practitioner1-153398AL

General Provider Information

NPI Number : 1043804701
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA HARRIS POWELL CRNP
Provider Business Mailing Address
First Line : 2201 JACK WARNER PKWY
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35401-1090
Country : US
Telephone Number : 205-523-5618
Fax Number :
Provider Business Practice Location Address
First Line : 2201 JACK WARNER PKWY
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35401-1090
Country : US
Telephone Number : 205-523-5618
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2021
Last Update Date : 11/03/2022

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