Provider Demographics
NPI:1114343811
Name:POOL, ANNA ARIEL (RN BSN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:ARIEL
Last Name:POOL
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:ARIEL
Other - Last Name:CULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN BSN
Mailing Address - Street 1:613 BEAR VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-6286
Mailing Address - Country:US
Mailing Address - Phone:970-270-0404
Mailing Address - Fax:
Practice Address - Street 1:2635 N 7TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8209
Practice Address - Country:US
Practice Address - Phone:970-270-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0190602163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse