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1073167573
DANITA RENAE POTTER
BASTROP, LA
NPI
1073167573
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA 206980)
Enumeration Date
2019-08-01
Last Update Date
2020-07-15
Business Address
Dr. DANITA RENAE POTTER PMHNP
518 DURHAM ST
BASTROP, LA 71220-5013
Phone number: 318-283-8887
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Mailing Address
Dr. DANITA RENAE POTTER PMHNP
PO BOX 792
BASTROP, LA 71221-0792
Phone number: 318-283-8887
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