Provider Demographics
NPI:1528452265
Name:POWELL, PATRICIA (FNP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 WELLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9406
Mailing Address - Country:US
Mailing Address - Phone:302-540-3752
Mailing Address - Fax:302-449-4383
Practice Address - Street 1:200 BANNING ST STE 210
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3487
Practice Address - Country:US
Practice Address - Phone:302-744-9645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000774363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily