Provider Demographics
NPI:1386626455
Name:POWELL, JANET C (WHNP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:C
Last Name:POWELL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:PROF
Other - First Name:JANET
Other - Middle Name:CAMPBELL
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WHNP
Mailing Address - Street 1:410 UNIVERSITY PKWY
Mailing Address - Street 2:SUITE 1550
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6810
Mailing Address - Country:US
Mailing Address - Phone:803-649-7535
Mailing Address - Fax:803-648-8771
Practice Address - Street 1:410 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 1550
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6810
Practice Address - Country:US
Practice Address - Phone:803-649-7535
Practice Address - Fax:803-648-8771
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCWH693363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC205980962OtherTAX ID #
SCNP0530Medicaid