Provider Demographics
NPI:1346437555
Name:POTTS, JANET (LPN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:POTTS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 SCHAFFER RD
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-9510
Mailing Address - Country:US
Mailing Address - Phone:740-663-5247
Mailing Address - Fax:
Practice Address - Street 1:1615 SCHAFFER RD
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-9510
Practice Address - Country:US
Practice Address - Phone:740-663-5247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN080532164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse