Individual
KAILEY LYNN POTRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-5673
(701) 234-7195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0725
ND
Other
Enumeration date
06/15/2018
Last updated
04/29/2022
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