Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | APRN1582462 | FL |
NPI | 1023077351 |
---|---|
Provider Name | Mrs. Jane A Powers |
First Address | Stuart, FL 34994 |
Second Address | Stuart, FL 34994 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 21/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0344214 | (05) | FL |