Individual
MRS. STEPHANIE EGLESTON POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 MAIN ST, HOPE VALLEY, RI 02832-1610
(401) 539-0283
Mailing address
6 FAIRWAY DR, HOPE VALLEY, RI 02832-3417
(401) 364-8786
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00198
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700867
—
RI
Enumeration date
02/16/2007
Last updated
07/08/2007
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