Provider Demographics
NPI:1891799631
Name:POWERS, CATHERINE H (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:H
Last Name:POWERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-0850
Mailing Address - Country:US
Mailing Address - Phone:423-538-5116
Mailing Address - Fax:423-538-3861
Practice Address - Street 1:229 HIGHWAY 19 E
Practice Address - Street 2:
Practice Address - City:BLUFF CITY
Practice Address - State:TN
Practice Address - Zip Code:37618-1865
Practice Address - Country:US
Practice Address - Phone:423-538-5116
Practice Address - Fax:423-538-3861
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN103469363LF0000X
TNAPN 7096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010196779Medicaid
TN3906378Medicaid
0281780001Medicare PIN
P05040Medicare UPIN
TN3906378Medicaid
TN3700592Medicare UPIN
TN103I086169Medicare UPIN
TNC30809Medicare PIN
TNP00272071Medicare PIN
0281780003Medicare PIN