Provider Demographics
NPI:1033173075
Name:POWERS, NANCY GAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:GAIL
Last Name:POWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N LORRAINE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4836
Mailing Address - Country:US
Mailing Address - Phone:316-260-8534
Mailing Address - Fax:316-260-9127
Practice Address - Street 1:509 N LORRAINE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4836
Practice Address - Country:US
Practice Address - Phone:316-260-8534
Practice Address - Fax:316-260-9127
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-25528208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSA49293Medicare UPIN