1093928491 NPI number — MRS. JOYCE J POOLE F.N.P.

Table of content: MRS. JOYCE J POOLE F.N.P. (NPI 1093928491)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093928491 NPI number — MRS. JOYCE J POOLE F.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POOLE
Provider First Name:
JOYCE
Provider Middle Name:
J
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
F.N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093928491
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
707 DR MICHAEL DEBAKEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE CHARLES
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70601-5728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-433-0762
Provider Business Mailing Address Fax Number:
337-433-4868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
707 DR MICHAEL DEBAKEY DR
Provider Second Line Business Practice Location Address:
NEURO ASSOCIATES
Provider Business Practice Location Address City Name:
LAKE CHARLES
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70601-5728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-433-0762
Provider Business Practice Location Address Fax Number:
337-433-4868
Provider Enumeration Date:
05/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  656491 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X , with the licence number: 317070 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com