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Individual

MARY V POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
289 W HUNTINGTON DR STE 205, ARCADIA, CA 91007-3492
(626) 353-8531
Mailing address
289 W HUNTINGTON DR, SUITE 205, ARCADIA, CA 91007-3495
(626) 353-8531

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
542206
CA
163WI0500X
Infusion Therapy Registered Nurse
542206
CA
163WP2201X
Ambulatory Care Registered Nurse
542206
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
430079592
RAILROAD MEDICARE
AZ
05
479594
AZ
Enumeration date
12/02/2005
Last updated
09/17/2014
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