MEDICARE: DR. PATRICIA JOANN VANDERPOOL DNP, FNP-BC, ANP-BC

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	363LF0000X	Family Nurse Practitioner	71002447B	IN
2	363LA2200X	Adult Health Nurse Practitioner	71002447B	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356546105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA JOANN VANDERPOOL DNP, FNP-BC, ANP-BC

Provider Business Mailing Address
First Line	:	1516 WASHINGTON ST
Second Line	:
City	:	NEW CASTLE
State	:	IN
Zip	:	47362-4355
Country	:	US
Telephone Number	:	765-836-5047
Fax Number	:	765-591-8171

Provider Business Practice Location Address
First Line	:	1516 WASHINGTON ST
Second Line	:
City	:	NEW CASTLE
State	:	IN
Zip	:	47362-4355
Country	:	US
Telephone Number	:	765-836-5047
Fax Number	:	765-591-8171

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	01/10/2017

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