Individual ProviderJana K. PowellNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140(260) 432-2297(260) 479-3515PECOS EnrollmentBased on the most recent information from CMS, provider Jana K. Powell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1710923503Provider TypeIndividualFull NamePowell, Jana K.CredentialNPGenderFemaleSole ProprietorNoEnumeration Date6/21/2006Last Updated1/19/2017Contact InformationPractice LocationPractice Address7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140Phone(260) 432-2297Fax(260) 479-2950Mailing LocationMailing Address6920 Pointe Inverness Way Ste 200, Medpartners, Attn: Megan Fortney, Fort Wayne, IN 46804-7934Phone(260) 479-3515Fax(260) 479-3520Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71000566AIndianaProvider IdentifiersIDDescriptionIssuerID200366330DescriptionMedicaidIssuerUnlistedIndianaID000000504551DescriptionOtherIssuerANTHEMIndianaIDP00400736DescriptionOtherIssuerMEDICARE - RAILROADIndiana