Basic Information
Provider Information
NPI: 1467123315
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POOLMAN
FirstName: EMMARIE
MiddleName: FEBE
NamePrefix: DR.
NameSuffix:  
Credential: ACNPC-AG
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193562633
FaxNumber: 3193562940
Practice Location
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193562633
FaxNumber: 3193562940
Other Information
ProviderEnumerationDate: 09/21/2021
LastUpdateDate: 12/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XH165739IAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LA2100XH165739IAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363LC0200XH165739IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine

No ID Information.


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