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NPI Code Detail

MEDICARE: CORTNEY POWELL

MEDICARE: CORTNEY POWELL
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
1363LF0000XFamily Nurse Practitioner23731SC

General Provider Information

NPI Number : 1093343147
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORTNEY POWELL
Provider Business Mailing Address
First Line : 3045 SAINT MATTHEWS RD
Second Line :
City : ORANGEBURG
State : SC
Zip : 29118-1443
Country : US
Telephone Number : 803-747-7242
Fax Number :
Provider Business Practice Location Address
First Line : 3045 SAINT MATTHEWS RD
Second Line :
City : ORANGEBURG
State : SC
Zip : 29118-1443
Country : US
Telephone Number : 803-747-7242
Fax Number : 803-747-7243
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2020
Last Update Date : 10/07/2021

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Directions to “ CORTNEY POWELL ” Practice Location

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