Individual
CHRISTOPHER POWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 815-1312
Mailing address
1065 RIDGESIDE DRIVE, BRANDON, MS 39042
(601) 201-1017
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R761402
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04533325
—
MS
01
—
202011213A
BLUE CROSS
MS
Enumeration date
06/15/2006
Last updated
11/06/2012
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