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ERICA HUMPHREY POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1000 WATERMAN WAY, TAVARES, FL 32778-5266
(321) 422-7156
Mailing address
5746 ANSLEY WAY, MOUNT DORA, FL 32757-8002

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
110372
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
9366265
FL

Other

Enumeration date
06/14/2016
Last updated
07/26/2016
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