Provider Demographics
NPI:1366323974
Name:POOLE, JAYNE ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:ANN
Last Name:POOLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2300 LINDBERG RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-3148
Mailing Address - Country:US
Mailing Address - Phone:765-641-2047
Mailing Address - Fax:765-641-2110
Practice Address - Street 1:3124 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-4509
Practice Address - Country:US
Practice Address - Phone:765-641-2103
Practice Address - Fax:765-641-2167
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28093158A163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool