Individual
MRS. ELLEN LOUISE POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2140 KINGSLEY AVE, SUITE 2, ORANGE PARK, FL 32073
(904) 886-4878
(904) 886-7438
Mailing address
PO BOX 57967, JACKSONVILLE, FL 32241-7967
(904) 886-4878
(904) 884-7438
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP668652
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300892400
—
FL
Enumeration date
05/15/2009
Last updated
05/15/2009
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