Healthcare Provider Details

I. General information

NPI: 1427805720
Provider Name (Legal Business Name): MALINDA POWELL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MAIN ST STE 2B
LANCASTER OH
43130-3478
US

IV. Provider business mailing address

PO BOX 278
POWELL OH
43065-0278
US

V. Phone/Fax

Practice location:
  • Phone: 740-654-0232
  • Fax: 740-654-9794
Mailing address:
  • Phone: 614-892-5365
  • Fax: 614-356-8540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberCNP.0036015
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: