MEDICARE: BREEZE ANN POWELL RN

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	163W00000X	Registered Nurse	201604703RN	OR

General Provider Information

NPI Number	:	1639627888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREEZE ANN POWELL RN

Provider Business Mailing Address
First Line	:	PO BOX 1374
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-0106
Country	:	US
Telephone Number	:	541-272-7428
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 SW COAST HWY
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-4988
Country	:	US
Telephone Number	:	541-265-0445
Fax Number	:	844-760-0526

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

Provider Enumeration Date	:	09/16/2016
Last Update Date	:	12/02/2025

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