Provider Demographics
NPI:1598887259
Name:POTTS, MARY KATE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATE
Last Name:POTTS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 ROSEBANK AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-1036
Mailing Address - Country:US
Mailing Address - Phone:615-226-1722
Mailing Address - Fax:
Practice Address - Street 1:VANDERBILT UNIVERSITY HOSPITAL
Practice Address - Street 2:1161 21ST AVE SOUTH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-322-7876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist