Provider Demographics
NPI:1093208241
Name:POOLE, CHRISTIE N (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:N
Last Name:POOLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 W CONGRESS ST STE 2300A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6778
Mailing Address - Country:US
Mailing Address - Phone:337-237-7801
Mailing Address - Fax:337-235-1865
Practice Address - Street 1:13333 DOTSON RD STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4305
Practice Address - Country:US
Practice Address - Phone:281-251-5234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1118046363LF0000X
LAAP10000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP10000Medicaid