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General NPI Number Information
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NPI Number | 1275930893
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Entity Type | Individual
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Provider Name | CASEY POWERS CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 3741 ROME DR # B
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City | LAFAYETTE
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State | IN
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Zip | 47905-4490
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Country | US
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Telephone | 765-607-6160
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 684
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City | DERBY
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State | VT
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Zip | 05829-0684
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Country | US
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Telephone | 765-586-8406
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 71012449A
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License Number State | IN
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