Provider Demographics
NPI:1326717919
Name:POWELL, SAOWANEE WINGWORN (DNP, APRN,FNP-C)
Entity Type:Individual
Prefix:DR
First Name:SAOWANEE
Middle Name:WINGWORN
Last Name:POWELL
Suffix:
Gender:F
Credentials:DNP, APRN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 COMMONWEALTH BLVD E
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2014
Mailing Address - Country:US
Mailing Address - Phone:276-638-7731
Mailing Address - Fax:
Practice Address - Street 1:429 COMMONWEALTH BLVD E
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2014
Practice Address - Country:US
Practice Address - Phone:276-638-7731
Practice Address - Fax:276-638-7735
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175727363LF0000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily