Provider Demographics
NPI:1841469863
Name:POTTER, MERTIE LORRAINE (DNP, ARNP, BC)
Entity type:Individual
Prefix:DR
First Name:MERTIE
Middle Name:LORRAINE
Last Name:POTTER
Suffix:
Gender:F
Credentials:DNP, ARNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SIMON ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3046
Mailing Address - Country:US
Mailing Address - Phone:603-888-4347
Mailing Address - Fax:035-779-1576
Practice Address - Street 1:39 SIMON ST STE 3A
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3046
Practice Address - Country:US
Practice Address - Phone:603-888-4347
Practice Address - Fax:035-779-1576
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-23
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH018534-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health