Individual
ANGELA RENEE POOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4415 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-6307
(850) 951-4556
(850) 951-4527
Mailing address
PO BOX 1100, WEST PLAINS, MO 65775-1100
(417) 256-9111
(417) 257-5947
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN11012186
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
R0072345
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447338603
—
MO
05
—
200100690A
—
OK
05
—
200804758
—
AR
01
—
248704113
MEDICARE ID
OK
01
—
5100141
AETNA
—
Enumeration date
11/02/2006
Last updated
03/21/2022
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