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General NPI Number Information
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NPI Number | 1093530701
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Entity Type | Organization
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Legal Business Name | LAURA POTTER DNP FNP-BC CONTRACTING SERVICES LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 19847 RIVERSIDE DR
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City | GRUNDY
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State | VA
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Zip | 24614
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Country | US
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Telephone | 276-248-0800
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Fax | 276-248-0814
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Provider Business Mailing Address
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Address Line | PO BOX 1051
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City | GRUNDY
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State | VA
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Zip | 24614-1051
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Country | US
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Telephone | 276-248-0800
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Fax | 276-248-0814
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | LAURA POTTER
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Credential | DNP
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Telephone | 423-946-3598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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