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Organization
BLACKHAWK MEDICAL, PLLC
Active
Organization
BLACKHAWK MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA LEA POWELL A-GPCNP (OWNER, NURSE PRACTITIONER)
(601) 624-1082
Entity
Organization
Contact information
Practice address
115 AULENBROCK DR # 100-B, CANTON, MS 39046-7061
(601) 624-1082
Mailing address
115 AULENBROCK DR # 100-B, CANTON, MS 39046-7061
(601) 624-1082
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
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