Healthcare Provider Details

I. General information

NPI: 1770839532
Provider Name (Legal Business Name): NICHOLAS PAUL POTTKOTTER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S MAIN ST
FINDLAY OH
45840-1214
US

IV. Provider business mailing address

1900 S MAIN ST
FINDLAY OH
45840-1214
US

V. Phone/Fax

Practice location:
  • Phone: 419-423-4500
  • Fax:
Mailing address:
  • Phone: 419-423-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.13626-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: