Individual
JOAN A POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
303 NW 11TH ST, FAIRFIELD, IL 62837-1203
(618) 842-2611
Mailing address
RR 3 BOX 658, FAIRFIELD, IL 62837-9568
(618) 847-7627
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
IL
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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