Provider Demographics
NPI:1801511332
Name:POTTER, BARBARA JEAN (DSP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:POTTER
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 PERCY ST
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-1450
Mailing Address - Country:US
Mailing Address - Phone:419-304-6554
Mailing Address - Fax:
Practice Address - Street 1:212 PERCY ST
Practice Address - Street 2:
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-1450
Practice Address - Country:US
Practice Address - Phone:419-304-6554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay