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Individual

TRACEY EARNETTE POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP

Contact information

Practice address
473 CABRILLO ST # B422, MONTEREY, CA 93944-3201
(831) 242-4328
Mailing address
1135 3RD ST, MONTEREY, CA 93940-3333
(614) 565-8939

Taxonomy

Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
RN284714APRNCNP10013
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN284714
OH
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
RN284714
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1588853816
NPI #
Enumeration date
10/23/2007
Last updated
07/31/2019
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