Individual
REGINA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5015 N 34TH ST BLDG 900, FOREST PARK, GA 30297-5245
(404) 469-4201
Mailing address
1040 FOREST OVERLOOK TRL SW, ATLANTA, GA 30331-8331
(404) 696-0840
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN078518 NP
GA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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