Provider Demographics
NPI:1164719225
Name:POOLE, ALLISON MICHAUD (PA)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MICHAUD
Last Name:POOLE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 PLEADES PL
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-2567
Mailing Address - Country:US
Mailing Address - Phone:303-704-2235
Mailing Address - Fax:
Practice Address - Street 1:698 BRIGGS ST.
Practice Address - Street 2:SUITE 4
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-5022
Practice Address - Country:US
Practice Address - Phone:303-704-2235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0003245363A00000X
COPA-3245363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant