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General NPI Number Information
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NPI Number | 1023744620
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Entity Type | Individual
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Provider Name | JESSICA LYNN POWELL PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 1414 3RD ST NW
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City | GREAT FALLS
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State | MT
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Zip | 59404-1928
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Country | US
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Telephone | 406-761-8420
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Fax | 406-727-0336
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Provider Business Mailing Address
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Address Line | 4240 4TH AVE N
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City | GREAT FALLS
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State | MT
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Zip | 59405-1224
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Country | US
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Telephone | 406-899-9238
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Fax | 406-727-0336
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA-PHA-LIC-88531
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License Number State | MT
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