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General NPI Number Information
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NPI Number | 1548136211
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Entity Type | Individual
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Provider Name | KEYANNE POTTER
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Gender |
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 909 EAGLES LANDING PKWY STE 440
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6398
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Country | US
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Telephone | 404-308-6705
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Fax | 217-302-7771
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Provider Business Mailing Address
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Address Line | 909 EAGLES LANDING PKWY STE 440
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6398
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Country | US
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Telephone | 404-308-6705
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Fax | 217-302-7771
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | PO31966
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License Number State | GA
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