Healthcare Provider Details

I. General information

NPI: 1730016809
Provider Name (Legal Business Name): PIPER ALEXANDRA POTEET
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 FAIRVIEW AVE STE 8
BOWLING GREEN KY
42101-2367
US

IV. Provider business mailing address

730 FAIRVIEW AVE STE 8
BOWLING GREEN KY
42101-2367
US

V. Phone/Fax

Practice location:
  • Phone: 615-348-5806
  • Fax:
Mailing address:
  • Phone: 615-348-5806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: