Provider Demographics
NPI:1093347635
Name:POWELL, CARI ALEXANDRIA (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:ALEXANDRIA
Last Name:POWELL
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 MCCALLIE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3323
Mailing Address - Country:US
Mailing Address - Phone:423-493-5220
Mailing Address - Fax:
Practice Address - Street 1:2205 MCCALLIE AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3323
Practice Address - Country:US
Practice Address - Phone:423-493-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN282114163W00000X
TNAPN0000030671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse