Provider Demographics
NPI:1851679476
Name:POUNDERS, MARK W (RN)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:W
Last Name:POUNDERS
Suffix:
Gender:M
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:UNIT 45013 BOX 3224
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338-5013
Mailing Address - Country:US
Mailing Address - Phone:937-886-6680
Mailing Address - Fax:
Practice Address - Street 1:UNIT 45013
Practice Address - Street 2:USA MEDDAC - JAPAN
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96338-5013
Practice Address - Country:US
Practice Address - Phone:315-263-4016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.317285163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator