Healthcare Provider Details

I. General information

NPI: 1891799631
Provider Name (Legal Business Name): CATHERINE H POWERS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 HIGHWAY 19 E
BLUFF CITY TN
37618-1865
US

IV. Provider business mailing address

PO BOX 850
ROGERSVILLE TN
37857-0850
US

V. Phone/Fax

Practice location:
  • Phone: 423-538-5116
  • Fax: 423-538-3861
Mailing address:
  • Phone: 423-538-5116
  • Fax: 423-538-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN103469
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 7096
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: