Individual
TIFFANY R. POTTKOTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
885 N SANDUSKY AVE, UPPER SANDUSKY, OH 43351-1098
(419) 294-4991
(419) 209-0278
Mailing address
885 N SANDUSKY AVE, UPPER SANDUSKY, OH 43351-1098
(419) 294-4991
(419) 209-0278
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C0500689
OH
101YP2500X
Professional Counselor
COA16281NP
OH
363L00000X
Nurse Practitioner
COA16281-NP
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.16281
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111791
—
OH
Enumeration date
06/11/2007
Last updated
03/06/2023
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