MEDICARE: DANA POTTER

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1730013152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA POTTER

Provider Business Mailing Address
First Line	:	1656 GARDEN ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101-2424
Country	:	US
Telephone Number	:	318-670-7447
Fax Number	:	318-725-7448

Provider Business Practice Location Address
First Line	:	1845 LINE AVE STE A
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101-4611
Country	:	US
Telephone Number	:	318-670-7447
Fax Number	:	318-725-7448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “ DANA POTTER ” Practice Location

Language	Start Address	Practice Location

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