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General NPI Number Information
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NPI Number | 1851062822
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Entity Type | Individual
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Provider Name | KELLY SUZANNE POWELL FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 101 WALNUT LN
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City | COLUMBIA
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State | TN
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Zip | 38401-4943
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Country | US
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Telephone | 931-381-3112
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Fax |
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Provider Business Mailing Address
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Address Line | 8911 N CAPITAL OF TEXAS HWY STE 1110
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City | AUSTIN
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State | TX
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Zip | 78759-7203
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Country | US
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Telephone | 877-279-5960
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 38020
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License Number State | TN
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