Provider Demographics
NPI:1578907259
Name:POTTER, JESSICA WARNKE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:WARNKE
Last Name:POTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEIGH
Other - Last Name:WARNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 980695
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0695
Mailing Address - Country:US
Mailing Address - Phone:804-828-2207
Mailing Address - Fax:804-828-8300
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:SURG: GENERAL SURGERY ACC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-7391
Practice Address - Fax:804-828-0191
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260942207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology