Provider Demographics
NPI:1154948446
Name:SOMERSET-POTTER, VANESSA (CRNP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:SOMERSET-POTTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17003-1643
Mailing Address - Country:US
Mailing Address - Phone:717-867-4671
Mailing Address - Fax:
Practice Address - Street 1:1251 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1643
Practice Address - Country:US
Practice Address - Phone:717-988-0531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily