Provider Demographics
NPI:1013134907
Name:POTTER, ANNETTE CHRISTINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:CHRISTINE
Last Name:POTTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:PIELA
Other - Last Name:POTTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2105 CLEARY AVE # 8999
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1623
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:2105 CLEARY AVE # 8999
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1623
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-081456363LF0000X
CA18058363LF0000X
LA212754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL891013880Medicaid
AL891013880Medicaid
AL891009470Medicaid
AL891013330Medicaid