Individual
JACQUELYN FAYE POTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7813 E 130TH CT, GRANDVIEW, MO 64030-2729
(816) 966-0048
Mailing address
7813 E 130TH CT, GRANDVIEW, MO 64030-2729
(816) 966-0048
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
111669
MO
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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