Provider Demographics
NPI:1417596438
Name:POWELL, ALICIA MICHELLE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MICHELLE
Last Name:POWELL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MISS
Other - First Name:ALICIA
Other - Middle Name:MICHELLE
Other - Last Name:KAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:
Practice Address - Street 1:4403 6TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-4733
Practice Address - Country:US
Practice Address - Phone:806-791-1122
Practice Address - Fax:806-791-2252
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily