MEDICARE: JANETTE POTTER ARNP

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	363LF0000X	Family Nurse Practitioner	ARNP9362936	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831602259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANETTE POTTER ARNP

Provider Business Mailing Address
First Line	:	1520 BUCK ST
Second Line	:
City	:	LAKE PLACID
State	:	FL
Zip	:	33852-9469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4005 SUN N LAKE BLVD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33872-2130
Country	:	US
Telephone Number	:	863-385-1400
Fax Number	:

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

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	11/07/2017

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