Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APN7706 | TN |
NPI | 1003925942 |
---|---|
Provider Name | Dr. Jill Powell |
First Address | Knoxville, TN 37924-1110 |
Second Address | Knoxville, TN 37919-4338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 11/01/2013 |