Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. SHIRLEY JEAN POOLE, RD CSP LDN
Active Sole ProprietorPediatric Nutrition · ROCKFORD, IL
Registration Details
- NPI Number
- 1205960705
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 15, 2007 (19.104219069824 yrs)
- Last Updated
- Jul 8, 2007
- Sole Proprietor
- Yes
Practice Information
- Address
-
1401 E STATE STROCKFORD, IL, 611042315Browse IL providers · Browse ZIP 61104
- Phone
- 8154894667
- Fax
- 8159645404
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.