Provider Demographics
NPI:1053098897
Name:POWERS, MICHELLE L
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 JAMES CT UNIT 27
Mailing Address - Street 2:
Mailing Address - City:MOUND HOUSE
Mailing Address - State:NV
Mailing Address - Zip Code:89706-8238
Mailing Address - Country:US
Mailing Address - Phone:775-720-1916
Mailing Address - Fax:
Practice Address - Street 1:325 VIOLA WAY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89704-9591
Practice Address - Country:US
Practice Address - Phone:775-473-5548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner