Powell, Kimberly Michelle

Powell, Kimberly Michelle is an individual health care provider with primary practice located at 2911 Roberts Ave , Tallahassee FL 32310-5007. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Powell, Kimberly Michelle can be contacted via phone (850) 644-1543.

Contact Information

Primary practice address
2911 Roberts Ave Tallahassee FL 32310-5007
Phone: (850) 644-1543
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 005568 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9117619 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005568 Georgia

Profile Details

NPI number 1700011178
LBN Legal business name Powell, Kimberly Michelle
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2009
Last updated Nov 14th, 2023 - about 2 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 1700011178 NPPES
Georgia MEDICAID 908821509A
Georgia MEDICAID 119357700

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