# SUSAN MARY POTTER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1831270420
- **Gender:** F
- **Credential:** FNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 520140 | TX | — |
| 363L00000X | Nurse Practitioner | 205349 | OK | Yes |
| 363L00000X | Nurse Practitioner | 520140 | TX | — |
| 363LF0000X | Family Nurse Practitioner | AP106025 | TX | — |
| 363LG0600X | Gerontology Nurse Practitioner | AP106025 | TN | — |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 06/02/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 8N9964 | BLUE CROSS & BLUE SHIELD | TX |