Healthcare Provider Details

I. General information

NPI: 1306245238
Provider Name (Legal Business Name): KARLY POWELL ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 E LAS ANIMAS ST
COLORADO SPRINGS CO
80903-4138
US

IV. Provider business mailing address

128 E LAS ANIMAS ST
COLORADO SPRINGS CO
80903-4138
US

V. Phone/Fax

Practice location:
  • Phone: 719-551-5282
  • Fax: 719-639-2054
Mailing address:
  • Phone: 719-551-5282
  • Fax: 719-639-2054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1999
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND.0000084
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: