Organization
KENDRA POOLE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA MAE POOLE APN (FNP/ OWNER)
(815) 303-4668
Entity
Organization
Contact information
Practice address
334 BACKBONE RD E, PRINCETON, IL 61356-9685
(815) 303-4668
(949) 862-8061
Mailing address
2215 STATE ST, PERU, IL 61354-3465
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831854744
—
IL
Enumeration date
11/04/2021
Last updated
02/20/2025
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