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General NPI Number Information
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NPI Number | 1285427682
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Entity Type | Individual
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Provider Name | TARA LYNE POWELL
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1701 OAK PARK BLVD
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8911
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Country | US
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Telephone | 337-494-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 36 EUCALYPTUS ST
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City | SULPHUR
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State | LA
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Zip | 70663-5508
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Country | US
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Telephone |
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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 | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 206257
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 206257
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License Number State | LA
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