Individual
STACEY ANN POOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, RN, PMHNP-BC
Contact information
Practice address
521 RISEN STAR DR, CRESTVIEW, FL 32539-6071
(480) 608-5157
Mailing address
521 RISEN STAR DR, CRESTVIEW, FL 32539-6071
(480) 808-9505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9559718
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
245674
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP145602
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11012113
FL
Other
Enumeration date
05/27/2020
Last updated
02/12/2024
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