Provider Demographics
NPI:1043762560
Name:POOLE-LITTLE, JANET (RN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:POOLE-LITTLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:POOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:519 S SAGINAW ST
Mailing Address - Street 2:SUITE 515
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1817
Mailing Address - Country:US
Mailing Address - Phone:810-953-2427
Mailing Address - Fax:810-853-6826
Practice Address - Street 1:519 S SAGINAW ST
Practice Address - Street 2:SUITE 515
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1817
Practice Address - Country:US
Practice Address - Phone:810-953-2427
Practice Address - Fax:810-853-6826
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704254476163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1514Medicaid