Provider Demographics
NPI:1831973460
Name:POWE, TIERRA WILLIAMS (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TIERRA
Middle Name:WILLIAMS
Last Name:POWE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12368 FLINT DR
Mailing Address - Street 2:
Mailing Address - City:MOUNDVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35474-6246
Mailing Address - Country:US
Mailing Address - Phone:251-282-6212
Mailing Address - Fax:
Practice Address - Street 1:1301 JACK WARNER PKWY NE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-1060
Practice Address - Country:US
Practice Address - Phone:205-792-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF06232156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily