Individual
VANESSA M POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18210 WRIGHT ST, OMAHA, NE 68130-2883
(531) 999-1813
(531) 999-2712
Mailing address
18210 WRIGHT ST, OMAHA, NE 68130-2883
(531) 999-1813
(531) 999-2712
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1490
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1490
NE STATE LICENSE
NE
Enumeration date
04/12/2010
Last updated
02/19/2025
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