Provider Demographics
NPI:1578063301
Name:POOLE, AISHIA SHERELL (RN)
Entity Type:Individual
Prefix:
First Name:AISHIA
Middle Name:SHERELL
Last Name:POOLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 COURTNEY CV
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-8007
Mailing Address - Country:US
Mailing Address - Phone:512-656-7995
Mailing Address - Fax:
Practice Address - Street 1:13915 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-6517
Practice Address - Country:US
Practice Address - Phone:512-996-9559
Practice Address - Fax:512-996-9905
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX851494163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse