Doctor Name: | ELIZABETH POTTER |
NPI Number: | 1154478162 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 3285P |
Business Practice Address: | 1219 West Main Street West Liberty, KY - 414721007 |
Business Phone Number: | 6067431600 |
Business Fax Number: | |
Mailing Address: | 1219 West Main St, WEST LIBERTY |
State: | KY |
Postal Code: | 414721007 |
Phone Number: | 6067431600 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2007 |
NPI Last Update Date: | 05/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3285P |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |