Provider Demographics
NPI:1548426588
Name:POWELL, CHRISTIN N (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:N
Last Name:POWELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 OLIVER RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5702
Mailing Address - Country:US
Mailing Address - Phone:318-327-7368
Mailing Address - Fax:318-327-7359
Practice Address - Street 1:920 OLIVER RD
Practice Address - Street 2:SUITE 600
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5702
Practice Address - Country:US
Practice Address - Phone:318-327-7368
Practice Address - Fax:318-327-7359
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05528363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics