Provider Demographics
NPI:1588105159
Name:POWERS, CAROL
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
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 1:201 58 ST SE #T007
Mailing Address - Street 2:
Mailing Address - City:WASHINGTO
Mailing Address - State:DC
Mailing Address - Zip Code:20019
Mailing Address - Country:US
Mailing Address - Phone:202-508-4098
Mailing Address - Fax:
Practice Address - Street 1:201 58 ST SE #T007
Practice Address - Street 2:
Practice Address - City:WASHINGTO
Practice Address - State:DC
Practice Address - Zip Code:20019
Practice Address - Country:US
Practice Address - Phone:202-508-4098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide