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General NPI Number Information
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NPI Number | 1568943587
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Entity Type | Individual
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Provider Name | BREANNA LAINE POTTER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 1508 BEGLIS PKWY
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City | SULPHUR
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State | LA
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Zip | 70663-5606
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Country | US
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Telephone | 337-625-2660
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Fax |
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Provider Business Mailing Address
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Address Line | 2577 MALL RD STE B
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City | FLORENCE
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State | AL
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Zip | 35630-1684
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Country | US
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Telephone | 256-246-2433
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PST.22481
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 57923
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 226768
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License Number State | AK
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302416426
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0020208
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-123712
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License Number State | KS
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Taxonomy #7
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20760
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License Number State | OK
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Taxonomy #8
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24412
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License Number State | NV
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Taxonomy #9
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18848
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License Number State | AL
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