MEDICARE: RENA POWELL CHURCH NP

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
1	363LF0000X	Family Nurse Practitioner	5005234	NC

General Provider Information

NPI Number	:	1750669842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENA POWELL CHURCH NP

Provider Business Mailing Address
First Line	:	3085 RICHLANDS HWY STE 4
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-2977
Country	:	US
Telephone Number	:	910-939-4848
Fax Number	:	910-939-4859

Provider Business Practice Location Address
First Line	:	3085 RICHLANDS HWY STE 4
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-2977
Country	:	US
Telephone Number	:	910-939-4848
Fax Number	:	910-939-4859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	06/05/2015

Similar Medicare Providers

1881619252 — MS. ALLISON KNOX DEVECHIO NP
Practice Location Address:

3085 RICHLANDS HWY STE 4
JACKSONVILLE, NC
28540-2977

Practice Phone: 910-939-4848
Practice Fax: 910-939-4859

1235670191 — LICE POLICE INC
Practice Location Address:

520 S MAIN ST
JACKSONVILLE, IL
62650-2977

Practice Phone: 217-204-9227
Practice Fax:

1013572304 — ALF 8860 ADRD TRAINING PROVIDER LLC.
Practice Location Address:

7990 BAYMEADOWS RD E UNIT 1001
JACKSONVILLE, FL
32256-2977

Practice Phone: 904-379-7359
Practice Fax: 904-379-7359

1184278384 — EVANS HOMEMAKING, COMPANION AND SITTER SERVICES LLC.
Practice Location Address:

7990 BAYMEADOWS RD E UNIT 1001
JACKSONVILLE, FL
32256-2977

Practice Phone: 904-379-7359
Practice Fax: 904-379-7359

1740015692 — CRISIS RECOVERY AND PROGRESSIVE PATH SERVICES INC.
Practice Location Address:

7990 BAYMEADOWS RD E UNIT 1001
JACKSONVILLE, FL
32256-2977

Practice Phone: 904-250-7363
Practice Fax: 904-374-2121

1184439572 — ERICA KAY EVANS
Practice Location Address:

7990 BAYMEADOWS RD E UNIT 1001
JACKSONVILLE, FL
32256-2977

Practice Phone: 904-250-7363
Practice Fax:

Directions to “ RENA POWELL CHURCH NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.