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NPI Code Detail

MEDICARE: PRISCILLA HAUG POOLE PA-C

MEDICARE: PRISCILLA HAUG POOLE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-10399NC

General Provider Information

NPI Number : 1558967885
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRISCILLA HAUG POOLE PA-C
Provider Business Mailing Address
First Line : 13845 CONLAN CIR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2705
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13845 CONLAN CIR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2705
Country : US
Telephone Number : 704-544-2092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2020
Last Update Date : 01/27/2026

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