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General NPI Number Information
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NPI Number | 1811618358
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Entity Type | Individual
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Provider Name | JAMIE LEANN POWERS APRN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 6210 MASSARD RD
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City | FORT SMITH
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State | AR
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Zip | 72916-8887
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Country | US
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Telephone | 918-721-5092
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Fax |
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Provider Business Mailing Address
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Address Line | 920 LAKE SPUR DR
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City | MANSFIELD
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State | AR
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Zip | 72944-8015
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Country | US
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Telephone | 918-721-5092
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 221580
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License Number State | AR
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