Provider Demographics
NPI:1326822180
Name:POWELL, SADIE NICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:NICHELLE
Last Name:POWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 E 80 NORTH CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5468
Mailing Address - Country:US
Mailing Address - Phone:435-668-0437
Mailing Address - Fax:
Practice Address - Street 1:2425 E 80 NORTH CIR
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5468
Practice Address - Country:US
Practice Address - Phone:435-668-0437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11101390-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse