Provider Demographics
NPI:1962658278
Name:POOLE, KARYN ANNE (MSN, RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:ANNE
Last Name:POOLE
Suffix:
Gender:F
Credentials:MSN, RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 N VERDE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-5574
Mailing Address - Country:US
Mailing Address - Phone:928-775-2281
Mailing Address - Fax:
Practice Address - Street 1:4220 N VERDE VISTA DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-5574
Practice Address - Country:US
Practice Address - Phone:928-775-2281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN092178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse