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NPI Code Detail

MEDICARE: ANGELA RENEE POOL ARNP

MEDICARE: ANGELA RENEE POOL ARNP
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
1261QR1300XRural Health Clinic/CenterAPRN11012186FL
2363LF0000XFamily Nurse PractitionerAPRN11012186FL
3363LP2300XPrimary Care Nurse PractitionerR0072345OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4248704113OTHEROKMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
55100141OTHERAETNA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447338603
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA RENEE POOL ARNP
Provider Business Mailing Address
First Line : PO BOX 1100
Second Line :
City : WEST PLAINS
State : MO
Zip : 65775-1100
Country : US
Telephone Number : 417-256-9111
Fax Number : 417-257-5947
Provider Business Practice Location Address
First Line : 21 W MAIN AVE
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32435-2529
Country : US
Telephone Number : 850-892-2888
Fax Number : 850-892-2405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 06/01/2026

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