Provider Demographics
NPI:1437832573
Name:POTAPA, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:POTAPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 CLEVELAND CT
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-1803
Mailing Address - Country:US
Mailing Address - Phone:616-419-6343
Mailing Address - Fax:
Practice Address - Street 1:2602 CLEVELAND CT
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-1803
Practice Address - Country:US
Practice Address - Phone:616-419-6343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula