Healthcare Provider Details

I. General information

NPI: 1104597897
Provider Name (Legal Business Name): EMILY POWELL DNP, APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 17TH ST
WOODWARD OK
73801-2448
US

IV. Provider business mailing address

900 17TH ST
WOODWARD OK
73801-2448
US

V. Phone/Fax

Practice location:
  • Phone: 580-254-8470
  • Fax:
Mailing address:
  • Phone: 580-254-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number205383
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number205383
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: