Individual
LONNA MARIE POTTER
Active
Individual
LONNA MARIE POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
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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