Provider Demographics
NPI:1467495465
Name:POWELL, JULIE KAY (DC, RN, MSN, FNP)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:KAY
Last Name:POWELL
Suffix:
Gender:F
Credentials:DC, RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 116762
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-6762
Mailing Address - Country:US
Mailing Address - Phone:972-931-6800
Mailing Address - Fax:972-248-0840
Practice Address - Street 1:1304 VILLAGE CREEK DR
Practice Address - Street 2:SUITE #300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4472
Practice Address - Country:US
Practice Address - Phone:972-931-6800
Practice Address - Fax:972-248-0840
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7323111NN0400X
TX774439163W00000X
TXAP120351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111NN0400XChiropractic ProvidersChiropractorNeurology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2429017OtherAETNA ID
TX2971285-01Medicaid
TX605768OtherBLUE CROSS BLUE SHIELD ID
TX0A3425Medicare PIN
TXTX141634Medicare PIN
TXTXB151979Medicare PIN
TXU68853Medicare UPIN
TXTXB141631Medicare PIN
TX2429017OtherAETNA ID