MEDICARE: MRS. ALLISON MICHAUD POOLE PA

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
1	363A00000X	Physician Assistant	PA0003245	CO
2	363A00000X	Physician Assistant	PA-3245	CO

General Provider Information

NPI Number	:	1164719225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON MICHAUD POOLE PA

Provider Business Mailing Address
First Line	:	341 PLEADES PL
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-2567
Country	:	US
Telephone Number	:	303-704-2235
Fax Number	:	785-328-4742

Provider Business Practice Location Address
First Line	:	698 BRIGGS ST.
Second Line	:	SUITE 4
City	:	ERIE
State	:	CO
Zip	:	80516-5022
Country	:	US
Telephone Number	:	303-704-2235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	01/05/2026

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