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General NPI Number Information
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NPI Number | 1205677143
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Entity Type | Individual
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Provider Name | JULIANNA MARIE POTTER NP
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 71 PROSPECT AVE
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City | HUDSON
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State | NY
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Zip | 12534-2927
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Country | US
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Telephone | 518-828-7601
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Fax |
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Provider Business Mailing Address
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Address Line | 128 KINDER DR
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City | KINDERHOOK
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State | NY
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Zip | 12106-2821
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Country | US
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Telephone | 518-755-4996
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F354139-01
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License Number State | NY
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