Healthcare Provider Details

I. General information

NPI: 1184552804
Provider Name (Legal Business Name): JAMES BRADLEY POWELL LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W PRATT ST
BALTIMORE MD
21201-2423
US

IV. Provider business mailing address

250 W PRATT ST STE 1100
BALTIMORE MD
21201-6806
US

V. Phone/Fax

Practice location:
  • Phone: 410-752-1712
  • Fax:
Mailing address:
  • Phone: 410-752-1712
  • Fax: 410-400-7075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number26510
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: