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Individual

LONNA MARIE POTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2820 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-5462
(605) 484-1828
Mailing address
5440 TIMBERLINE TRL, RAPID CITY, SD 57702-1806

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000712
SD
367500000X
Certified Registered Nurse Anesthetist
R033602
SD
367500000X
Certified Registered Nurse Anesthetist
R29308
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R033602
LICENSE
SD
Enumeration date
11/03/2008
Last updated
12/28/2023
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