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NPI 1639799414

NPI 1639799414 : CANDICE TURNER POTTER PHARMD : KINSTON, NC

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General NPI Number Information
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    NPI Number           |    1639799414
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    Entity Type          |    Individual 
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    Provider Name        |    CANDICE TURNER POTTER PHARMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/21/2020
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    Last Update Date     |    04/21/2020
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Provider Practice Location Address
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    Address Line         |    701 DOCTORS DR STE P 
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    City                 |    KINSTON
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    State                |    NC
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    Zip                  |    28501-1584
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    Country              |    US
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    Telephone            |    252-523-3187
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    Fax                  |    252-522-2988
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Provider Business Mailing Address
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    Address Line         |    701 DOCTORS DR STE P 
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    City                 |    KINSTON
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    State                |    NC
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    Zip                  |    28501-1584
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    Country              |    US
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    Telephone            |    252-523-3187
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    Fax                  |    252-522-2988
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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       |    19048
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    License Number State |    NC
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