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NPI Code Detail

MEDICARE: PEGGIE L POWELL DNP FNP-BC

MEDICARE:   PEGGIE L POWELL  DNP FNP-BC
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
1363LP2300XPrimary Care Nurse Practitioner0024166112VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00362126OTHERVACC RR MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1740286939
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGIE L POWELL DNP FNP-BC
Provider Business Mailing Address
First Line : 1755 N MECKLENBURG AVE
Second Line :
City : SOUTH HILL
State : VA
Zip : 23970-4080
Country : US
Telephone Number : 434-584-2273
Fax Number : 434-584-5517
Provider Business Practice Location Address
First Line : 1755 N MECKLENBURG AVE
Second Line :
City : SOUTH HILL
State : VA
Zip : 23970-4080
Country : US
Telephone Number : 434-584-2273
Fax Number : 434-584-5517
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 02/03/2026

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