Provider Demographics
NPI:1780980383
Name:POWERS, CHRISTINE (M S)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:M S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 V I RANCH RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-0940
Mailing Address - Country:US
Mailing Address - Phone:423-217-0047
Mailing Address - Fax:
Practice Address - Street 1:2603 OSBORNE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-2326
Practice Address - Country:US
Practice Address - Phone:276-669-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001489231H00000X
VA2102002610237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist