Individual
KENDRA RAE POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4221 FORT HENRY DR STE 1, KINGSPORT, TN 37663-2227
(423) 726-2672
(423) 406-1399
Mailing address
4221 FORT HENRY DR STE 1, KINGSPORT, TN 37663-2227
(423) 726-2672
(423) 406-1399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110008946
VA
363A00000X
Physician Assistant
Primary
4173
TN
363A00000X
Physician Assistant
—
TN
363AM0700X
Medical Physician Assistant
4173
TN
Other
Enumeration date
05/16/2019
Last updated
07/31/2025
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