Provider Demographics
NPI:1518291483
Name:POWELL, MIA ELLEN (RNFA)
Entity Type:Individual
Prefix:
First Name:MIA
Middle Name:ELLEN
Last Name:POWELL
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16835 ALGONQUIN ST STE 396
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-3810
Mailing Address - Country:US
Mailing Address - Phone:562-833-1698
Mailing Address - Fax:562-683-2798
Practice Address - Street 1:16835 ALGONQUIN ST STE 396
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-3810
Practice Address - Country:US
Practice Address - Phone:562-833-1698
Practice Address - Fax:562-683-2798
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN603089163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant