Provider Demographics
NPI:1285907436
Name:POWELL, LYNN LOWERY
Entity type:Individual
Prefix:MR
First Name:LYNN
Middle Name:LOWERY
Last Name:POWELL
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 1:1772 S ALABAMA AVE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36460-3062
Mailing Address - Country:US
Mailing Address - Phone:251-743-4410
Mailing Address - Fax:251-743-4465
Practice Address - Street 1:1772 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-3062
Practice Address - Country:US
Practice Address - Phone:251-743-4410
Practice Address - Fax:251-743-4465
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist