| Elizabeth Poole, | |
|
103 Fram Street, Petersburg, AK 99833 | |
| (907) 772-4291 | |
| Not Available |
| Full Name | Elizabeth Poole |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 103 Fram Street, Petersburg, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013369206 | NPI | - | NPPES |
| 018249900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 129230 (Alaska) | Primary |
| Entity Name | The Petersburg Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437122843 PECOS PAC ID: 5395730626 Enrollment ID: O20040416000917 |
| Entity Name | The Petersburg Medical Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1437122843 PECOS PAC ID: 5395730626 Enrollment ID: O20061104000713 |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Poole, Po Box 589, Petersburg, AK 99833-0589 Ph: (907) 772-4291 | Elizabeth Poole, 103 Fram Street, Petersburg, AK 99833 Ph: (907) 772-4291 |
Angela Dawn Menish, APRN, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 103 Fram Street, Petersburg, AK 99833 Phone: 907-772-4299 Fax: 907-772-9273 | |
Ms. Stacey Reynolds Dahl, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 103 Fram Treet, Petersburg, AK 99833 Phone: 907-772-4291 Fax: 907-773-3085 |