Provider Demographics
NPI:1093988586
Name:POTASH, DRU ALLISON (PNP)
Entity Type:Individual
Prefix:
First Name:DRU
Middle Name:ALLISON
Last Name:POTASH
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 UNION SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2084
Mailing Address - Country:US
Mailing Address - Phone:615-206-1100
Mailing Address - Fax:615-206-9742
Practice Address - Street 1:1005 UNION SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2084
Practice Address - Country:US
Practice Address - Phone:615-206-1100
Practice Address - Fax:615-206-9742
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13191363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN13191OtherAPN
TN157405OtherRN