KIMBERLY LOUISE POWELL (Credential# 1528305) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
KIMBERLY LOUISE POWELL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.004207. The credential type is physician assistant. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 1382 Bishop Rd, Grosse Pointe Park, MI 48230. The current status is active.
| Licensee Name | KIMBERLY LOUISE POWELL |
| Credential ID | 1528305 |
| Credential Number | 23.004207 |
| Credential Type | Physician Assistant |
| Business Address |
1382 Bishop Rd Grosse Pointe Park MI 48230 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-08-24 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-05-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1595336 | CSP.0069402 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-08-24 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 1382 Bishop Rd |
| City | Grosse Pointe Park |
| State | MI |
| Zip Code | 48230 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Amber Lynn Braker | 722 Balfour St, Grosse Pointe Park, CT 48230 | Emergency Medical Technician | ~ |
| Pamela H Bawden | 1039 Yorkshire, Grosse Pointe, MI 48230 | Real Estate Salesperson | 2009-06-01 ~ 2010-05-31 |
| Kevin D Carter | 936 Barrington Rd, Grosse Pointe, MI 48230 | Architect | 2015-08-01 ~ 2016-07-31 |
| Borivoje Trifunovic | 456 Heff Road, Grosse Pointe City, MI 48230 | Physician/surgeon | ~ |
| Rosetta Farber | 943 Harcourt, Grosse Point Park, MI 48230 | Registered Nurse | 2001-07-23 ~ 2002-04-30 |
| Sharon A Leshner | 11 Lakeside Court, Grosse Pointe, MI 48230 | Registered Nurse | 1997-03-11 ~ 1998-05-31 |
| Mary L Donahue | 1357 Beaconsfield, Grosse Pointe Park, MI 48230 | Physical Therapist | 1998-08-28 ~ 1999-08-31 |
| David M Kelley | 1265 Bedford, Grosse Point, MI 48230 | Electrical Unlimited Journeyperson | ~ |
| S. Michael Maxim | 288 Fisher Rd, Grosse Pointe Farms, MI 48230-1215 | Hairdresser/cosmetician | 2009-09-29 ~ 2010-12-31 |
| Anthony J Mucciante | 1153 Lakepointe St, Grosse Pointe Park, MI 48230-1319 | Paramedic | 2017-11-01 ~ 2018-10-31 |
| Find all Licenses in zip 48230 | |||
| City | Grosse Pointe Park |
| Zip Code | 48230 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Grosse Pointe Park |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea M Powell | 552 West 165th St., New York, NY 10032 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Allyssa Louise Kenney | 520 Roosevelt Ave, Springfield, MA 01118-1100 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Louise Middaugh | 6974 S Hohokam Place, Gold Canyon, AZ 85118 | Physician Assistant | ~ |
| Emily Louise Skane | 61 Greenhurst Rd, West Hartford, CT 06107-3419 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Kimberly Keane | Kimberly Keane Pa-c, Derby, CT 06418 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Kimberly A Sweezy | 21 Collier Rd, Wethersfield, CT 06109-3525 | Physician Assistant | 2020-03-01 ~ 2021-02-28 |
| Kimberly Budd | 21 Beacon Ave, Auburn, ME 04210-5001 | Physician Assistant | 2012-08-01 ~ 2013-07-31 |
| Kimberly A Meyer Pa-c | 85 Seymour St Ste 725, Hartford, CT 06106 | Physician Assistant | 2007-07-09 ~ 2008-08-31 |
| Kimberly Birch | 20 Maple St, N Tarrytown, NY 10591 | Physician Assistant | 1997-12-04 ~ 1998-12-31 |
| Diane C Erianne Pa | 10 Kimberly Lane, Watertown, CT 06795 | Physician Assistant | 2012-05-01 ~ 2013-04-30 |
Please comment or provide details below to improve the information on KIMBERLY LOUISE POWELL.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).