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General NPI Number Information
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NPI Number | 1760105589
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Entity Type | Individual
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Provider Name | TANYA LYNETTE POWERS AGNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 1100 GROSSCUP AVE
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City | DUNBAR
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State | WV
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Zip | 25064-3120
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Country | US
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Telephone | 304-768-8811
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Fax | 304-768-4072
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Provider Business Mailing Address
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Address Line | 1100 GROSSCUP AVE
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City | DUNBAR
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State | WV
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Zip | 25064-3120
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Country | US
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Telephone | 304-768-8811
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Fax | 304-768-4072
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 114490
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License Number State | WV
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