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General NPI Number Information
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NPI Number | 1508181900
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Entity Type | Individual
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Provider Name | JANELLE TYLER POOLE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 5845 E STILL CIR STE 104
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City | MESA
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State | AZ
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Zip | 85206-3635
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Country | US
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Telephone | 623-334-4000
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Fax | 623-334-4400
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Provider Business Mailing Address
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Address Line | 20715 E OCOTILLO RD SUITE 102
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6118
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Country | US
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Telephone | 480-987-0987
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Fax | 480-987-0940
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP3584
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License Number State | AZ
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