Provider Demographics
NPI:1396437257
Name:POE, CAROL (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:POE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 ALLBRITTON RD
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180-2663
Mailing Address - Country:US
Mailing Address - Phone:205-946-4580
Mailing Address - Fax:
Practice Address - Street 1:1189 ALLBRITTON RD
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-2663
Practice Address - Country:US
Practice Address - Phone:205-946-4580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-140064363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health