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NPI Code Detail

MEDICARE: DEBRA JOY POWELL APN

MEDICARE: DEBRA JOY POWELL APN
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
1363LW0102XWomen's Health Nurse PractitionerIL

General Provider Information

NPI Number : 1730196023
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA JOY POWELL APN
Provider Business Mailing Address
First Line : 13245 KESSLER RD
Second Line : PO BOX 233
City : CAIRO
State : IL
Zip : 62914-3101
Country : US
Telephone Number : 618-734-4400
Fax Number : 618-734-2884
Provider Business Practice Location Address
First Line : 13245 KESSLER RD
Second Line :
City : CAIRO
State : IL
Zip : 62914-3101
Country : US
Telephone Number : 618-734-4400
Fax Number : 618-734-2884
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 07/08/2007

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