MEDICARE: DANIEL JOSEPH POWERS FNP-C

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	363LF0000X	Family Nurse Practitioner	0024176221	VA

General Provider Information

NPI Number	:	1871087940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL JOSEPH POWERS FNP-C

Provider Business Mailing Address
First Line	:	5009 FILLMORE AVE APT 200
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-5009
Country	:	US
Telephone Number	:	615-389-4517
Fax Number	:

Provider Business Practice Location Address
First Line	:	4660 KENMORE AVE STE 600
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1314
Country	:	US
Telephone Number	:	703-212-9190
Fax Number	:

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

Provider Enumeration Date	:	06/21/2018
Last Update Date	:	06/21/2018

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