Provider Demographics
NPI:1063062065
Name:POTTER, CORTNEY LYNN
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:LYNN
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 1:117 BOOGALOO LN
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-4360
Mailing Address - Country:US
Mailing Address - Phone:806-470-7599
Mailing Address - Fax:
Practice Address - Street 1:117 BOOGALOO LN
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-4360
Practice Address - Country:US
Practice Address - Phone:806-470-7599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula