Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 02004653A | IN |
NPI | 1093071250 |
---|---|
Provider Name | Shannon K Powell |
First Address | New Orleans, LA 70118 |
Second Address | New Orleans, LA 70118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2012 |
Last Update Date | 20/09/2019 |