Individual
MS. MARY ELIZABETH MONTICELLO POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
410 S 11TH ST, LAKE WALES, FL 33853-4203
(863) 419-2188
(863) 419-2540
Mailing address
410 S 11TH ST, LAKE WALES, FL 33853-4203
(863) 419-2188
(863) 419-2540
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5976
CO
363L00000X
Nurse Practitioner
ARNP2085022
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN2085022
FL
Other
Enumeration date
12/22/2006
Last updated
10/20/2020
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