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NPI Code Detail

MEDICARE: PATRICIA LYNN POTEET CFNP-BC, PMHNP-BC

MEDICARE: PATRICIA LYNN POTEET CFNP-BC, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5640TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14091713OTHERBLUE CROSS OF TN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508865197
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA LYNN POTEET CFNP-BC, PMHNP-BC
Provider Business Mailing Address
First Line : 584 CONGRESS PKWY S
Second Line :
City : ATHENS
State : TN
Zip : 37303-2258
Country : US
Telephone Number : 865-637-9711
Fax Number :
Provider Business Practice Location Address
First Line : 201 W SPRINGDALE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-5158
Country : US
Telephone Number : 865-637-9711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 03/20/2017

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