Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 12705 | TN |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN149487 | TN |
NPI | 1013036961 |
---|---|
Provider Name | Renee Barbre Powell |
First Address | Knoxville, TN 37912-2728 |
Second Address | Knoxville, TN 37912-2728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 27/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3097665 | (05) | TN |