Organization
DEMENTIA CONSULTATIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHILOMENA MAE POOLE RN GNP-BC (NURSE PRACTITIONER, SOLE PROPRIETER)
(608) 647-6538
Entity
Organization
Contact information
Practice address
265 NORTH PARK STREET, RICHLAND CENTER, WI 53581-2208
(608) 647-6538
Mailing address
265 NORTH PARK STREET, RICHLAND CENTER, WI 53581-2208
(608) 647-6538
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
964-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629079348
NPI TYPE 1
—
05
—
43849300
—
WI
Enumeration date
05/05/2008
Last updated
05/05/2008
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