Provider Demographics
NPI:1427805720
Name:POWELL, MALINDA (FNP-C)
Entity type:Individual
Prefix:
First Name:MALINDA
Middle Name:
Last Name:POWELL
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-0278
Mailing Address - Country:US
Mailing Address - Phone:614-892-5365
Mailing Address - Fax:614-356-8540
Practice Address - Street 1:1500 E MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3478
Practice Address - Country:US
Practice Address - Phone:740-654-0232
Practice Address - Fax:740-654-9794
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.0036015207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine