Healthcare Provider Details

I. General information

NPI: 1699927962
Provider Name (Legal Business Name): ANATHEA CARLSON POWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2008
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY STE 900
RENO NV
89502-1464
US

IV. Provider business mailing address

1155 MILL ST # M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-6270
  • Fax: 775-982-6271
Mailing address:
  • Phone: 775-982-6270
  • Fax: 775-982-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number239021-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number56046
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number27036
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: