Provider Demographics
NPI:1508181900
Name:POOLE, JANELLE TYLER (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:TYLER
Last Name:POOLE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:TYLER
Other - Last Name:BARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20715 E OCOTILLO RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6118
Mailing Address - Country:US
Mailing Address - Phone:480-987-0987
Mailing Address - Fax:480-987-0940
Practice Address - Street 1:5845 E STILL CIR STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3635
Practice Address - Country:US
Practice Address - Phone:623-334-4000
Practice Address - Fax:623-334-4400
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3584363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily