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Individual

MARK H POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, RN

Contact information

Practice address
675 THUNDERBOLT AVE, LAKE HAVASU CITY, AZ 86406-7100
(928) 486-2910
Mailing address
675 THUNDERBOLT AVE, LAKE HAVASU CITY, AZ 86406-7100
(928) 486-2910
(928) 415-4291

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN077937
AZ
163WA2000X
Administrator Registered Nurse
RN077937
AZ
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN077937
AZ

Other

Enumeration date
04/27/2010
Last updated
01/15/2024
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