Doctor Name: | LEIGH ANNE POTTS |
NPI Number: | 1801289707 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | ARNP9198950 |
Business Practice Address: | 775 Malabar Rd Malabar, FL - 329503120 |
Business Phone Number: | 3217228435 |
Business Fax Number: | 3217228486 |
Mailing Address: | Po Box 1137, MELBOURNE |
State: | FL |
Postal Code: | 329021137 |
Phone Number: | 3219529696 |
Fax Number: | 3219527937 |
NPI Enumeration Date: | 03/17/2015 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | ARNP9198950 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |