MEDICARE: NOAH POWERS CNP

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	363L00000X	Nurse Practitioner	0034882	OH

General Provider Information

NPI Number	:	1396523015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH POWERS CNP

Provider Business Mailing Address
First Line	:	239 RIVERS BREEZE CT
Second Line	:
City	:	NEW RICHMOND
State	:	OH
Zip	:	45157-3400
Country	:	US
Telephone Number	:	260-515-4054
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 VERULAM AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-2417
Country	:	US
Telephone Number	:	513-631-1310
Fax Number	:

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

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	09/15/2023

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