Provider Demographics
NPI:1417123282
Name:AMES POWERS, ANGELA FAYE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:FAYE
Last Name:AMES POWERS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:FAYE
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:106 EASTON ST
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:MO
Mailing Address - Zip Code:63020-1706
Mailing Address - Country:US
Mailing Address - Phone:636-337-5522
Mailing Address - Fax:636-337-5525
Practice Address - Street 1:106 EASTON ST
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-1706
Practice Address - Country:US
Practice Address - Phone:636-337-5522
Practice Address - Fax:636-337-5525
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO126672207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine