Provider Demographics
NPI:1972625937
Name:POWERS, KATHALEEN F (RN, FNP)
Entity type:Individual
Prefix:MRS
First Name:KATHALEEN
Middle Name:F
Last Name:POWERS
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:MRS
Other - First Name:KATHALEEN
Other - Middle Name:F
Other - Last Name:JANTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:2503 WESTFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090
Mailing Address - Country:US
Mailing Address - Phone:615-476-4850
Mailing Address - Fax:615-343-0047
Practice Address - Street 1:1900 BELLMONT BLVD
Practice Address - Street 2:BELLMONT UNIVERSITY STUDENT HEALTH CENTER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212
Practice Address - Country:US
Practice Address - Phone:615-460-5534
Practice Address - Fax:615-343-0047
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341532Medicare UPIN