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Individual

TARA LYNE POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-3000
Mailing address
36 EUCALYPTUS ST, SULPHUR, LA 70663-5508

Taxonomy

Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
206257
LA
363L00000X
Nurse Practitioner
Primary
206257
LA

Other

Enumeration date
05/28/2025
Last updated
10/09/2025
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