Provider Demographics
NPI:1659763100
Name:POWELL, CASEY HODGIN (FNP-C, RN)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:HODGIN
Last Name:POWELL
Suffix:
Gender:F
Credentials:FNP-C, RN
Other - Prefix:MS
Other - First Name:CASEY
Other - Middle Name:JOY
Other - Last Name:HODGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4274 ALBERNY PLACE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265
Mailing Address - Country:US
Mailing Address - Phone:336-702-8140
Mailing Address - Fax:
Practice Address - Street 1:500 SHEPHERD STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:WINSTON - SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-713-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily