Provider Demographics
NPI:1417627613
Name:POWE, BRITTANY N (CNM)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:N
Last Name:POWE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 COUNTY ROAD 610
Mailing Address - Street 2:
Mailing Address - City:SHUBUTA
Mailing Address - State:MS
Mailing Address - Zip Code:39360-9306
Mailing Address - Country:US
Mailing Address - Phone:601-917-2449
Mailing Address - Fax:
Practice Address - Street 1:1171 COUNTY ROAD 610
Practice Address - Street 2:
Practice Address - City:SHUBUTA
Practice Address - State:MS
Practice Address - Zip Code:39360-9306
Practice Address - Country:US
Practice Address - Phone:601-917-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049484367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife