Individual
HEATHER A POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
115 HUSTON DR, SUITE 1, SHEPHERDSVILLE, KY 40165-7250
(502) 955-7311
(502) 955-9694
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3003365
KY
363LF0000X
Family Nurse Practitioner
3365P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78005717
—
KY
Enumeration date
11/17/2006
Last updated
12/05/2018
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