Valerie Louise Potter, LPN

Individual provider Active NPI Licensed Practical Nurse · Augusta, WV

NPI 1104215565 · NPPES record last updated Jan 22, 2015

Key facts

NPI
1104215565
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
25435 (WV)
Practice address
4928 Ford Hill Road
Augusta, WV 26704
Phone
(304) 851-4459
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0002088630VAMDLicensed Practical Nurse
25435WVMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 25435 WV Yes
Licensed Practical Nurse 164W00000X 0002088630 VA

Addresses

Primary practice location

4928 Ford Hill Road
Augusta, WV 26704

Mailing address

4928 Ford Hill Road
Augusta, WV 26704
Phone (304) 851-4459

Other providers in Augusta, WV

All providers in Augusta, WV · Licensed Practical Nurse in West Virginia

Sources for this page

Verify at the official NPI Registry.