Provider Demographics
NPI:1801887096
Name:POTTS, HEATHER L (CNM, FNP,BC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:L
Last Name:POTTS
Suffix:
Gender:F
Credentials:CNM, FNP,BC
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:LAFEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, FNP, BC
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 THE VANDERBILT CLINIC
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-2652
Practice Address - Country:US
Practice Address - Phone:615-936-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8225207Q00000X, 367A00000X
TNAPN8225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P87926Medicare UPIN
TN3345683Medicare PIN
34950121Medicare PIN