Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN287101 | GA |
NPI | 1023762937 |
---|---|
Provider Name | Alexandria Kathleen Powell |
First Address | Suwanee, GA 30024-4622 |
Second Address | Atlanta, GA 30303-3031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2022 |
Last Update Date | 09/02/2022 |