Healthcare Provider Details

I. General information

NPI: 1316677255
Provider Name (Legal Business Name): EMILY ALINA POTTS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 JAHNKE RD
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

7101 JAHNKE RD
RICHMOND VA
23225-4017
US

V. Phone/Fax

Practice location:
  • Phone: 804-483-0745
  • Fax:
Mailing address:
  • Phone: 804-483-0745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1053129
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024193852
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: