Provider Demographics
NPI:1881021863
Name:POTEETE, RUTH ANN (LPN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:POTEETE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-6846
Mailing Address - Country:US
Mailing Address - Phone:423-465-1825
Mailing Address - Fax:
Practice Address - Street 1:179 OVERHILL RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-6846
Practice Address - Country:US
Practice Address - Phone:423-465-1825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN81000164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse