Individual
KENDRA DEON POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0P2574
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM00PA38
BCBS
NM
Enumeration date
10/23/2006
Last updated
02/13/2019
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