Healthcare Provider Details

I. General information

NPI: 1962345298
Provider Name (Legal Business Name): AMY POOLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 MEADOW LN
SPRINGFIELD OH
45505-1659
US

IV. Provider business mailing address

456 MEADOW LN
SPRINGFIELD OH
45505-1659
US

V. Phone/Fax

Practice location:
  • Phone: 937-206-7615
  • Fax:
Mailing address:
  • Phone: 937-206-7615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: