Provider Demographics
NPI:1538627369
Name:POWELL, ALICIA (DIRECT ENTRY MIDWIFE)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:DIRECT ENTRY MIDWIFE
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DIRECT ENTRY MIDWIFE
Mailing Address - Street 1:570 E 900 N
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1335
Mailing Address - Country:US
Mailing Address - Phone:435-592-5440
Mailing Address - Fax:435-572-4634
Practice Address - Street 1:622 N 900 E STE 4
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1696
Practice Address - Country:US
Practice Address - Phone:435-592-5440
Practice Address - Fax:435-572-4634
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay