Provider Demographics
NPI:1598288987
Name:POTLER, HANNAH (NP-BC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:POTLER
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ELMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3333
Mailing Address - Country:US
Mailing Address - Phone:413-626-2758
Mailing Address - Fax:
Practice Address - Street 1:85 1ST AVE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1105
Practice Address - Country:US
Practice Address - Phone:781-647-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1479784163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse