Provider Demographics
NPI:1518963602
Name:POWERS, CATHY L (FNP)
Entity Type:Individual
Prefix:PROF
First Name:CATHY
Middle Name:L
Last Name:POWERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7130 BELL ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-7003
Mailing Address - Country:US
Mailing Address - Phone:806-373-4010
Mailing Address - Fax:806-373-4051
Practice Address - Street 1:7130 BELL STREET
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109
Practice Address - Country:US
Practice Address - Phone:806-373-4010
Practice Address - Fax:806-373-4051
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092856603OtherTEXAS HEALTH STEPS
TX092856602Medicaid
553824Medicare UPIN
NP0052Medicare ID - Type Unspecified