Individual
LAN POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2640 57TH CIR E APT 202, ELLENTON, FL 34222
(319) 671-2270
Mailing address
2640 57TH CIR E APT 202, 2640 57TH CIR E APT 202, ELLENTON, FL 34222
(319) 671-2270
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN11032275
FL
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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