Provider Demographics
NPI:1932343548
Name:POTTER, SHERRI A
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:A
Last Name:POTTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1344
Mailing Address - Street 2:512 COLORADO BLVD.
Mailing Address - City:IDAHO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80452-1344
Mailing Address - Country:US
Mailing Address - Phone:303-567-2767
Mailing Address - Fax:303-567-2767
Practice Address - Street 1:512 COLORADO BLVD.
Practice Address - Street 2:
Practice Address - City:IDAHO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80452
Practice Address - Country:US
Practice Address - Phone:303-567-2767
Practice Address - Fax:303-567-2767
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider