Provider Demographics
NPI:1851080659
Name:POWELL, TINA MARIE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:POWELL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 N MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-4208
Mailing Address - Country:US
Mailing Address - Phone:419-425-5121
Mailing Address - Fax:419-425-5738
Practice Address - Street 1:3949 N MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4208
Practice Address - Country:US
Practice Address - Phone:419-425-5121
Practice Address - Fax:419-425-5738
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF03200523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily