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Individual
MRS. KIMBERLY MICHELLE POWELL
Active
Individual
MRS. KIMBERLY MICHELLE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
005568
GA
363A00000X
Physician Assistant
Primary
9117619
FL
363AS0400X
Surgical Physician Assistant
005568
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119357700
—
FL
05
—
908821509A
—
GA
Enumeration date
05/28/2009
Last updated
11/14/2023
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