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NPI Code Detail

MEDICARE: JACQUELINE AUDREYMENIA POWELL MD

MEDICARE: JACQUELINE AUDREYMENIA POWELL MD
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
1207L00000XAnesthesiology Physician41012KY
2207L00000XAnesthesiology Physician47944AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000521683OTHERKYANTHEM/BCBS

General Provider Information

NPI Number : 1134125230
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE AUDREYMENIA POWELL MD
Provider Business Mailing Address
First Line : PO BOX 22410
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93390-2410
Country : US
Telephone Number : 502-619-2464
Fax Number :
Provider Business Practice Location Address
First Line : 2215 TRUXTUN AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-3602
Country : US
Telephone Number : 661-632-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 01/23/2025

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Directions to “ JACQUELINE AUDREYMENIA POWELL MD” Practice Location

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