| NPI | 1316933807 |
|---|---|
| Former Name | LAURIE A POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AZ AP1284) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN114181) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2018-07-24 |