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General NPI Number Information
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NPI Number | 1609799717
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Entity Type | Organization
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Legal Business Name | POTTER WELLNESS & PRIMARY CARE LLC
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 10982 N 1970 RD
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City | ELK CITY
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State | OK
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Zip | 73644-6423
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Country | US
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Telephone | 580-821-0626
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Fax |
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Provider Business Mailing Address
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Address Line | 10982 N 1970 RD
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City | ELK CITY
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State | OK
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Zip | 73644-6423
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Country | US
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Telephone | 580-821-0626
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SADIE MARIE POTTER
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Credential | APRN-CNP
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Telephone | 580-821-0626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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