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General NPI Number Information
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NPI Number | 1740806991
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Entity Type | Individual
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Provider Name | JASMINE POWELL
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Gender | Female
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 4041 KNIGHT ARNOLD RD STE 100
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City | MEMPHIS
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State | TN
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Zip | 38118-2128
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Country | US
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Telephone | 901-572-1573
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Fax | 901-360-0865
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Provider Business Mailing Address
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Address Line | 59 PEAVINE RD
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City | BOYLE
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State | MS
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Zip | 38730-9513
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Country | US
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Telephone | 662-402-2943
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 903300
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License Number State | MS
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