National Provider Identifier

Kim Maureen Potter

Kim Maureen Potter is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Marion, NY and a listed phone number of (315) 584-3314.

NPI 1679163661Marion, NYLicensed Practical Nurse

Profile Overview

NPI
1679163661
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
January 22, 2021
Last Updated
January 22, 2021

Practice Location

  • 3477 Palmyra RD
  • Marion, NY 14505-9711

Phone: (315) 584-3314

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1679163661
Entity Type
Individual
Last Name
Potter
First Name
Kim
Middle Name
Maureen
Mailing Street Address
3477 Palmyra RD
Mailing City
Marion
Mailing State
NY
Mailing ZIP Code
14505-9711
Mailing Country
US
Mailing Phone
(315) 584-3314
Practice Street Address
3477 Palmyra RD
Practice City
Marion
Practice State
NY
Practice ZIP Code
14505-9711
Practice Country
US
Practice Phone
(315) 584-3314
Enumeration Date
January 22, 2021
Last Updated
January 22, 2021
Sex
Female
Sole Proprietor
Yes
Certification Date
January 22, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)