Provider Demographics
NPI:1689887176
Name:POWELL, NAOMI D (RN)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:D
Last Name:POWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 OSCEOLA DR
Mailing Address - Street 2:
Mailing Address - City:WHITWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37397-5635
Mailing Address - Country:US
Mailing Address - Phone:423-658-2408
Mailing Address - Fax:
Practice Address - Street 1:110 GAMBLE LN
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-2811
Practice Address - Country:US
Practice Address - Phone:423-942-2238
Practice Address - Fax:423-942-9186
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000115586163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health