Poole, Kevin Roy

Poole, Kevin Roy is an individual health care provider with primary practice located at 12500 Aurora Dr , Pleasant Prairie WI 53158-1227. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Poole, Kevin Roy can be contacted via phone (262) 857-5000.

Contact Information

Primary practice address
12500 Aurora Dr Pleasant Prairie WI 53158-1227
Phone: (262) 857-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 7400 Wisconsin

Profile Details

NPI number 1477529915
LBN Legal business name Poole, Kevin Roy
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Oct 19th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477529915 NPPES
Wisconsin MEDICAID 100252142

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