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Individual
SOPHIE POULIOT
Active
Individual
SOPHIE POULIOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
122671
IA
363A00000X
Physician Assistant
Primary
TC076
KY
363AM0700X
Medical Physician Assistant
TC076
KY
363AS0400X
Surgical Physician Assistant
TC076
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/07/2022
Last updated
09/14/2026
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