Provider Demographics
NPI:1659928083
Name:POTTS, KARA L (NP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:L
Last Name:POTTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:LYNN
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 79777
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0777
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:844-831-8777
Practice Address - Street 1:435 MERCHANT WALK SQ STE 400
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-6516
Practice Address - Country:US
Practice Address - Phone:434-654-1800
Practice Address - Fax:844-883-6065
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177809363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily