Powell, Jacqueline Audreymenia

Powell, Jacqueline Audreymenia is an individual health care provider with primary practice located at 2421 E Southern Ave Suite 1, Tempe AZ 85282. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Powell, Jacqueline Audreymenia can be contacted via phone (480) 425-2160.

Contact Information

Primary practice address
2421 E Southern Ave Suite 1 Tempe AZ 85282
Phone: (480) 425-2160
Fax: (480) 351-8797
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 41012 Kentucky
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 47944 Arizona

Profile Details

NPI number 1134125230
LBN Legal business name Powell, Jacqueline Audreymenia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Feb 15th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134125230 NPPES
Kentucky Other 000000521683 ANTHEM/BCBS

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