Individual
KIMBERLIE POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
23 CENTRAL ST, MORAVIA, NY 13118-3427
(315) 497-9066
(315) 497-3836
Mailing address
17 MAIN ST, SUITE 302, CORTLAND, NY 13045-6606
(607) 753-3797
(607) 753-6677
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F333065-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02639201
—
NY
Enumeration date
07/26/2006
Last updated
01/19/2012
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