Individual
MS. SUSAN ELIZABETH POTTS-NULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CRNP
Contact information
Practice address
VAMC UNIVERSITY AND WOODLAND AVE, PHILADELPHIA, PA 19104
(215) 823-5800
(215) 823-4411
Mailing address
8056 CRISPIN ST, PHILADELPHIA, PA 19136-2625
(215) 823-5800
(215) 823-4411
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP000997C
PA
363LA2200X
Adult Health Nurse Practitioner
SP000997C
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SP000997C
PA
Other
Enumeration date
09/05/2006
Last updated
04/21/2022
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