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Individual
M ANDREA POWELL
Active
Individual
M ANDREA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008559
NY
363A00000X
Physician Assistant
Primary
085004223
IL
Other
Enumeration date
04/17/2007
Last updated
01/10/2020
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