Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0024131477 | VA |
NPI | 1033233606 |
---|---|
Provider Name | Laura Powell |
First Address | Fredericksburg, VA 22401-3375 |
Second Address | Fredericksburg, VA 22401-3375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 18/02/2013 |