Individual
LAURA POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 BOULDERS PKWY STE 110, NORTH CHESTERFIELD, VA 23225-5513
(804) 410-9749
(804) 272-3498
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024173812
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06115
GROUP PTAN
VA
Enumeration date
08/04/2016
Last updated
04/01/2022
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