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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700011178 | NPPES |
| Georgia | MEDICAID | 908821509A | |
| Georgia | MEDICAID | 119357700 |
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