Individual
KEVIN POOLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
3044 SHABAY DR BLDG 1, FLUSHING, MI 48433-2459
(810) 265-8514
Mailing address
3044 SHABAY DR BLDG 1, FLUSHING, MI 48433-2459
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
4704350959
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704350959
NURSING LICENSE
MI
Enumeration date
07/01/2020
Last updated
07/01/2020
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