Individual
JASON D POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5366 MENDENHALL MALL, MEMPHIS, TN 38115-4505
(901) 271-6100
(901) 271-6199
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104
(901) 260-8551
(901) 260-8590
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
180760
TN
363LF0000X
Family Nurse Practitioner
Primary
15618
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1525673
—
TN
Enumeration date
04/27/2011
Last updated
03/15/2012
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