MEDICARE: JOSEPHINE M POTTS CRNP

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	SP021029	PA

General Provider Information

NPI Number	:	1932747540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE M POTTS CRNP

Provider Business Mailing Address
First Line	:	3601 MCKNIGHT EAST DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-6400
Country	:	US
Telephone Number	:	412-369-9943
Fax Number	:	412-369-9447

Provider Business Practice Location Address
First Line	:	5201 BAUM BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-2303
Country	:	US
Telephone Number	:	412-687-3627
Fax Number	:

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

Provider Enumeration Date	:	12/13/2019
Last Update Date	:	07/11/2024

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