Provider Demographics
NPI:1801159124
Name:POWELL, VONZELL WILLIAM VALERIAN II (LPN)
Entity type:Individual
Prefix:MR
First Name:VONZELL
Middle Name:WILLIAM VALERIAN
Last Name:POWELL
Suffix:II
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5618 SANDBROOK LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9417
Mailing Address - Country:US
Mailing Address - Phone:614-384-6095
Mailing Address - Fax:855-244-3344
Practice Address - Street 1:5618 SANDBROOK LN
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9417
Practice Address - Country:US
Practice Address - Phone:614-384-6095
Practice Address - Fax:855-244-3344
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.136327-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse