Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 8086 | MN |
NPI | 1003491366 |
---|---|
Provider Name | Mrs. Sarah Lynne Potts |
First Address | Saint Paul, MN 55102-2568 |
Second Address | Saint Paul, MN 55102-2568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2021 |
Last Update Date | 22/06/2021 |