Individual
PHILIP POTENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 473-0055
(757) 473-0075
Mailing address
134 BUSINESS PARK DR, VIRGINIA BEACH, VA 23462-6523
(757) 473-0055
(757) 473-0075
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001250777
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024174507
VA
Other
Enumeration date
01/12/2017
Last updated
02/07/2017
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