Provider Demographics
NPI:1194439091
Name:POOLE, ANNA (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:POOLE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 CONSTITUTION WAY
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2956
Mailing Address - Country:US
Mailing Address - Phone:713-884-0033
Mailing Address - Fax:
Practice Address - Street 1:19220 S I-35 FRONTAGE RD
Practice Address - Street 2:300
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640
Practice Address - Country:US
Practice Address - Phone:737-265-3964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1105861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily