Provider Demographics
NPI:1922721505
Name:POOL, CHARLOTTE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:POOL
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:HUDNUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10138 HULL STREET RD STE C
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3357
Mailing Address - Country:US
Mailing Address - Phone:804-276-8011
Mailing Address - Fax:
Practice Address - Street 1:10138 HULL STREET RD STE C
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3357
Practice Address - Country:US
Practice Address - Phone:804-276-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185151363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily