Individual
MRS. MICHELLE TRACY POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1992
(918) 494-6455
Mailing address
7617 S QUEBEC PL, TULSA, OK 74136-8108
(303) 919-6293
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0126433
OK
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-306045
VA
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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