Individual
MS. TINA J POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4643 N 12TH ST, PHILA, PA 19140-1227
(267) 592-7907
Mailing address
4643 N 12TH ST, PHILA, PA 19140-1227
(267) 592-7907
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN310309
PA
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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