Individual
MRS. SHIRLEY LUCILLE POWELL
Active
Individual
MRS. SHIRLEY LUCILLE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
672043
—
363AM0700X
Medical Physician Assistant
Primary
16701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09315405
CERTIFIED DIABETES EDUCAT
—
01
—
16701
PHYSICIAN ASSISTANT
CA
01
—
672043
REGISTERED DIETITIAN
—
Enumeration date
09/06/2006
Last updated
03/07/2023
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