Individual
LISA GAIL POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2580 HIGHWAY 95, #1250, BULLHEAD CITY, AZ 86442-7491
(928) 763-7776
(928) 763-7786
Mailing address
2580 HIGHWAY 95, #1250, BULLHEAD CITY, AZ 86442-7491
(928) 763-7776
(928) 763-7786
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
75803
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75803
KANSAS LICENSE
KS
05
—
SBHS
—
AZ
Enumeration date
03/29/2013
Last updated
07/27/2016
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