Individual
MICHAEL POULIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, APRN
Contact information
Practice address
21 LOCUST ST, RENO, NV 89502-1316
(775) 982-5270
(775) 982-5288
Mailing address
850 HARVARD WAY # T5, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN14274
NV
363LF0000X
Family Nurse Practitioner
Primary
APRN001757
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12675644
CAQH
—
05
—
1306265723
—
NV
01
—
2014015653
ANCC
—
Enumeration date
04/14/2014
Last updated
10/30/2018
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