Individual provider Active NPI

Nancy Louise Poulson, RN

  • Registered Nurse
  • Columbia City, IN
National Provider Identifier
1912915612
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28066533A Issued in IN
Practice address
885 W Connexion Way
Ste 100
Columbia City, IN 46725-1044
Phone
(260) 244-0010
Fax
(260) 244-0070
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28066533A IN Primary

Addresses

Primary practice location

885 W Connexion Way
Ste 100
Columbia City, IN 46725-1044

Mailing address

885 W Connexion Way
Ste 100
Columbia City, IN 46725-1044
Phone (260) 244-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28066533AINMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912915612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 W CONNEXION WAY",
            "address_2": "STE 100",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467251044",
            "telephone_number": "260-244-0010",
            "fax_number": "260-244-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 W CONNEXION WAY",
            "address_2": "STE 100",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467251044",
            "telephone_number": "260-244-0010",
            "fax_number": "260-244-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "NANCY",
        "middle_name": "LOUISE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28066533A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.