| NPI | 1164359790 |
|---|---|
| Former Name | KELLY POTTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA RN742967) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 130959) |
| Enumeration Date | 2026-05-07 |
| Last Update Date | 2026-05-07 |