Individual
NICOLE MARIE POTHAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNM
Contact information
Practice address
433 W HIGH ST, BRYAN, OH 43506-1690
(419) 636-1131
(419) 636-3100
Mailing address
433 W HIGH ST, BRYAN, OH 43506-1690
(419) 636-5414
(419) 636-3100
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
019332
OH
367A00000X
Advanced Practice Midwife
71006654
IN
Other
Enumeration date
10/12/2016
Last updated
04/08/2020
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