Healthcare Provider Details

I. General information

NPI: 1639627888
Provider Name (Legal Business Name): BREEZE ANN POWELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BREEZE A POWELL SPIVEY RN

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 SW COAST HWY
NEWPORT OR
97365-4988
US

IV. Provider business mailing address

PO BOX 1374
NEWPORT OR
97365-0106
US

V. Phone/Fax

Practice location:
  • Phone: 541-265-0445
  • Fax: 844-760-0526
Mailing address:
  • Phone: 541-272-7428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201604703RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: