Individual
MRS. ROBERTA LEE POOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
140 BRYAN BLVD, CORBIN, KY 40701-2775
(606) 523-2005
(606) 523-9704
Mailing address
140 BRYAN BLVD, CORBIN, KY 40701-2775
(606) 523-2005
(606) 523-9704
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4101P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000601701
ANTHEM
KY
05
—
78010717
—
KY
Enumeration date
01/10/2006
Last updated
11/18/2010
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