Provider Demographics
NPI:1548914781
Name:POWERS, KEARSTEN T
Entity type:Individual
Prefix:MISS
First Name:KEARSTEN
Middle Name:T
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WINDBEAM AVE
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-1805
Mailing Address - Country:US
Mailing Address - Phone:862-377-9674
Mailing Address - Fax:
Practice Address - Street 1:50 WINDBEAM AVE
Practice Address - Street 2:
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-1805
Practice Address - Country:US
Practice Address - Phone:862-377-9674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer