Provider Demographics
NPI:1336193689
Name:POWELL, WARSEAL (CRNP)
Entity type:Individual
Prefix:
First Name:WARSEAL
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:WARSEAL
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1009 WINDCROSS CT
Mailing Address - Street 2:STE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2678
Mailing Address - Country:US
Mailing Address - Phone:615-224-5438
Mailing Address - Fax:855-247-8787
Practice Address - Street 1:1100 MERCANTILE LN STE 135
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5361
Practice Address - Country:US
Practice Address - Phone:301-773-9700
Practice Address - Fax:301-773-4900
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1092007363L00000X
MDAC003086363LP0808X
MDR182162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL631400166Medicaid
AL631400166Medicaid