Doctor Name: | JOANNA POTTER |
NPI Number: | 1154705622 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | R 0089621 |
Business Practice Address: | 201 E Chestnut Ave Ponca City, OK - 746014311 |
Business Phone Number: | 5807636017 |
Business Fax Number: | 5807636059 |
Mailing Address: | 201 E Chestnut Ave, PONCA CITY |
State: | OK |
Postal Code: | 746014311 |
Phone Number: | 5807636017 |
Fax Number: | 5807636059 |
NPI Enumeration Date: | 07/15/2015 |
NPI Last Update Date: | 07/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | R 0089621 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |