Individual
JALYSSIA D POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3529 DENTON HWY, HALTOM CITY, TX 76117-3293
(817) 779-0707
Mailing address
5306 GREENSHAVEN DR, FORT WORTH, TX 76112-8720
(817) 779-0707
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
1191934
TX
Other
Enumeration date
05/18/2026
Last updated
05/18/2026
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