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General NPI Number Information
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NPI Number | 1174856736
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Entity Type | Individual
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Provider Name | JESSICA ELIZABETH POWELL APRN
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Gender | Female
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 216 N MERIDIAN RD STE 4
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City | NEWTON
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State | KS
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Zip | 67114-5119
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Country | US
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Telephone | 316-300-3246
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Fax |
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Provider Business Mailing Address
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Address Line | 216 N MERIDIAN RD STE 4
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City | NEWTON
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State | KS
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Zip | 67114-5119
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Country | US
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Telephone | 316-300-3246
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Fax | 866-659-1837
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 53-75032-011
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License Number State | KS
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