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Individual

MRS. BUELAH LISA POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
1678 PERSHING ST, VALLEY STREAM, NY 11580-1207
(516) 561-8943
(516) 561-8943
Mailing address
1678 PERSHING ST, VALLEY STREAM, NY 11580-1207
(516) 561-8943
(516) 561-8943

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
566692
NY
363LF0000X
Family Nurse Practitioner
Primary
338455
NY

Other

Enumeration date
12/27/2013
Last updated
02/07/2014
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