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General NPI Number Information
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NPI Number | 1205248218
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Entity Type | Individual
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Provider Name | KIMBERLY AGUPITAN POWERS CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/24/2014
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Last Update Date | 06/14/2015
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Provider Practice Location Address
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Address Line | 44139 MONTEREY AVE STE B
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City | PALM DESERT
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State | CA
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Zip | 92260-8700
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Country | US
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Telephone | 760-773-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 128 TESORI DR
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City | PALM DESERT
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State | CA
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Zip | 92211-0799
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Country | US
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Telephone | 909-223-8766
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 656241
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 95000313
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License Number State | CA
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