Organization
POTTER MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA F POTTER FNP (MANGER FNP)
(662) 820-3999
Entity
Organization
Contact information
Practice address
1462 HIGHWAY 1 S, GREENVILLE, MS 38701-7140
(662) 702-5121
(662) 702-5123
Mailing address
205 N DEER CREEK DR E, LELAND, MS 38756-2749
(662) 820-3999
(662) 702-5121
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R857846
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08175511
—
MS
Enumeration date
04/08/2016
Last updated
01/31/2019
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