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General NPI Number Information
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NPI Number | 1588622153
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Entity Type | Individual
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Provider Name | KATRINA D. POWERS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 19401 E 39TH ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2308
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Country | US
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Telephone | 816-490-4277
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Fax | 855-446-7160
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Provider Business Mailing Address
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Address Line | PO BOX 616788
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City | ORLANDO
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State | FL
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Zip | 32861-6788
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Country | US
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Telephone | 407-533-6837
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Fax | 407-770-0661
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD105933
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License Number State | MO
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