Individual
QWANA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
201 BAKER BLVD, LELAND, MS 38756-3401
(662) 686-4121
(662) 686-4770
Mailing address
201 BAKER BLVD, LELAND, MS 38756-3401
(662) 686-4121
(662) 686-4770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
883315
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
905295
MS
Other
Enumeration date
06/30/2023
Last updated
12/18/2023
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