Doctor Name: | NICHOLE MARIE POTTS |
NPI Number: | 1174957666 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 53-76064-012 |
Business Practice Address: | 403 Sycamore St Valley Falls, KS - 660881318 |
Business Phone Number: | 7859453263 |
Business Fax Number: | |
Mailing Address: | 403 Sycamore St, VALLEY FALLS |
State: | KS |
Postal Code: | 660881318 |
Phone Number: | 7859453263 |
Fax Number: | |
NPI Enumeration Date: | 09/03/2013 |
NPI Last Update Date: | 09/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 53-76064-012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |