Provider Demographics
NPI:1386442820
Name:POWELL, DENISE C (CSFA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:C
Last Name:POWELL
Suffix:
Gender:
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 S PEARL ST APT 9
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-4703
Mailing Address - Country:US
Mailing Address - Phone:575-694-1661
Mailing Address - Fax:
Practice Address - Street 1:1111 S PEARL ST APT 9
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-4703
Practice Address - Country:US
Practice Address - Phone:575-694-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant