Individual
JUDY A POWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
400 E TICKLE ST, DYERSBURG, TN 38024-3120
(731) 285-2410
Mailing address
PO BOX 501041, SAINT LOUIS, MO 63150-0001
(731) 285-2410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
8779
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3606317
—
TN
01
—
4083431
BSTN
TN
Enumeration date
03/07/2006
Last updated
07/08/2007
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