Christie Rose Potter, APRN

Individual provider Active NPI Family Nurse Practitioner · Happy, KY

NPI 1184178592 · NPPES record last updated Aug 15, 2016

Key facts

NPI
1184178592
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
3010615 (KY)
Practice address
397 Upper Doty Branch Rd
Happy, KY 41746-8951
Phone
(303) 901-0526
NPI assigned
Aug 15, 2016
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)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3010615KYMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3010615 KY Yes

Addresses

Primary practice location

397 Upper Doty Branch Rd
Happy, KY 41746-8951

Mailing address

PO Box 1132
Seneca, IL 61360-1132
Phone (303) 901-0526

Other providers in Happy, KY

All providers in Happy, KY · Family Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.