MEDICARE: KAYLA ANN POWERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704353588	MI
2	363L00000X	Nurse Practitioner	4704353588	MI

General Provider Information

NPI Number	:	1063291730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA ANN POWERS

Provider Business Mailing Address
First Line	:	10927 MELBOURNE AVE
Second Line	:
City	:	ALLEN PARK
State	:	MI
Zip	:	48101-1171
Country	:	US
Telephone Number	:	313-909-2619
Fax Number	:

Provider Business Practice Location Address
First Line	:	1770 FORT ST
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-1904
Country	:	US
Telephone Number	:	313-466-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2023
Last Update Date	:	12/09/2025

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Directions to “ KAYLA ANN POWERS ” Practice Location

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