Individual
MR. KENNETH JAMES POWELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 E LAUREL RD, STRATFORD, NJ 08084-1327
(856) 346-6000
Mailing address
18 E LAUREL RD, STRATFORD, NJ 08084-1327
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR21318400
NJ
163W00000X
Registered Nurse
RN636091
PA
363L00000X
Nurse Practitioner
Primary
26NJ01288700
NJ
Other
Enumeration date
01/26/2022
Last updated
04/01/2022
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