Provider Demographics
NPI:1447363635
Name:POWERS, PHILIP JOHN (CRNA)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:JOHN
Last Name:POWERS
Suffix:
Gender:M
Credentials:CRNA
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 1800
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68602-1800
Mailing Address - Country:US
Mailing Address - Phone:402-564-7118
Mailing Address - Fax:402-562-3378
Practice Address - Street 1:4600 38TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1664
Practice Address - Country:US
Practice Address - Phone:402-564-7118
Practice Address - Fax:402-562-3378
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100529367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE277098OtherCOVENTRY
NE4029OtherMIDLANDS
NE430025409OtherRAILROAD
NE430025409OtherRAILROAD