Provider Demographics
NPI:1528218401
Name:POWERS, YOLANDA LYNN
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:LYNN
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JODY
Other - Middle Name:LYNN
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2201 N BROADWELL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2153
Mailing Address - Country:US
Mailing Address - Phone:308-382-3660
Mailing Address - Fax:
Practice Address - Street 1:2221 NORTH BROADWELL AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803
Practice Address - Country:US
Practice Address - Phone:308-382-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist