Provider Demographics
NPI:1467944561
Name:POWELL, NADIA CHRISTINE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:NADIA
Middle Name:CHRISTINE
Last Name:POWELL
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 N BUCKNER BLVD STE 407
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3407
Mailing Address - Country:US
Mailing Address - Phone:972-729-9010
Mailing Address - Fax:469-947-6767
Practice Address - Street 1:29 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-2401
Practice Address - Country:US
Practice Address - Phone:516-517-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137303363LF0000X, 363LP0808X
NY346159363LF0000X
NY403910363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily