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1992700272

NPI Code Detail

MEDICARE: MRS. MAUREEN ADRIAN POE APRN

MEDICARE: MRS. MAUREEN ADRIAN POE APRN

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	207QA0505X	Adult Medicine Physician	AP01864	LA
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	AP01864	LA
3	363LG0600X	Gerontology Nurse Practitioner	AP01864	LA

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	:	1992700272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAUREEN ADRIAN POE APRN

Provider Business Mailing Address
First Line	:	6464 CORBINA RD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-7674
Country	:	US
Telephone Number	:	337-526-6774
Fax Number	:	337-375-0021

Provider Business Practice Location Address
First Line	:	921 1ST AVE
Second Line	:
City	:	SULPHUR
State	:	LA
Zip	:	70663-3424
Country	:	US
Telephone Number	:	337-526-6774
Fax Number	:	337-375-0021

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	12/18/2024

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Directions to “ MRS. MAUREEN ADRIAN POE APRN” Practice Location

Language	Start Address	Practice Location

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