Individual
KEVIN C POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
ROUTE 264 MP 388, POLACCA, AZ 86042
(928) 737-6000
Mailing address
485 S 350 E # 32-1, ROOSEVELT, UT 84066-3344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9008535-3102
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
03/05/2020
Last updated
03/05/2020
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