Individual
COREY A POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1808 SHERMAN DR, PRINCETON, IN 47670
(812) 385-3400
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28162089A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353810
BLUE SHIELD
IN
01
—
000000682757
ANTHEM
—
05
—
200510270
—
IN
01
—
P00219322
RAILROAD MEDICARE
—
Enumeration date
05/10/2006
Last updated
04/19/2011
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