| Doctor Name: | KAREN V POTAMPA |
| NPI Number: | 1174687867 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NMNP-PP |
| License Number: | 26221N1 |
| Business Practice Address: | 76 Ne 12th St Madras, OR - 977411827 |
| Business Phone Number: | 5414753874 |
| Business Fax Number: | 5414753503 |
| Mailing Address: | 76 Ne 12th St, MADRAS |
| State: | OR |
| Postal Code: | 977411827 |
| Phone Number: | 5414753874 |
| Fax Number: | 5414753503 |
| NPI Enumeration Date: | 12/20/2006 |
| NPI Last Update Date: | 09/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 26221N1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |