Provider Demographics
NPI:1457397481
Name:STRICKLAND, IRENE POWELL (FNP)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:POWELL
Last Name:STRICKLAND
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 1:1458 MINNIE VADA LN
Mailing Address - Street 2:
Mailing Address - City:STEDMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28391-8956
Mailing Address - Country:US
Mailing Address - Phone:910-483-4515
Mailing Address - Fax:
Practice Address - Street 1:1309 MEDICAL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4425
Practice Address - Country:US
Practice Address - Phone:910-437-5130
Practice Address - Fax:910-437-5128
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1174575179Medicare UPIN