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Individual
STEPHANIE KATHRYN POTTER
Active
Individual
STEPHANIE KATHRYN POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M-10113
ID
207Q00000X
Family Medicine Physician
M-16783
ID
207Q00000X
Family Medicine Physician
MD177584
OR
207Q00000X
Family Medicine Physician
MR-0872
ID
207Q00000X
Family Medicine Physician
Primary
N-3251
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1196215
MEDICARE PTAN
ID
05
—
1609892413
—
ID
01
—
P01009617
MEDICARE RAILROAD
ID
Enumeration date
07/14/2006
Last updated
07/31/2026
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