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General NPI Number Information
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NPI Number | 1033824693
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Entity Type | Individual
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Provider Name | SHANNON ELIZABETH POTTER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 1 RAILROAD AVE
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City | NEWFIELDS
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State | NH
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Zip | 03856-8406
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Country | US
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Telephone | 603-810-0002
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Fax | 603-772-3601
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Provider Business Mailing Address
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Address Line | 1 RAILROAD AVE
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City | NEWFIELDS
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State | NH
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Zip | 03856-8406
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Country | US
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Telephone | 603-810-0002
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Fax | 603-696-3547
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 080466-21
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 080466-21
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License Number State | NH
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