Provider Demographics
NPI:1124386610
Name:POWELL, NORA E (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:E
Last Name:POWELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47305-2529
Mailing Address - Country:US
Mailing Address - Phone:765-284-3991
Mailing Address - Fax:
Practice Address - Street 1:3400 W COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5459
Practice Address - Country:US
Practice Address - Phone:765-289-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004095A172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker