Provider Demographics
NPI:1225401847
Name:POTTER, AMY CATHERINE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CATHERINE
Last Name:POTTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:CATHERINE
Other - Last Name:SELLERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2105 E SOUTH BLVD
Mailing Address - Street 2:NICU-AMY POTTER, CRNP
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2409
Mailing Address - Country:US
Mailing Address - Phone:334-286-2823
Mailing Address - Fax:334-286-2824
Practice Address - Street 1:2105 E SOUTH BLVD
Practice Address - Street 2:NICU-AMY POTTER, CRNP
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2409
Practice Address - Country:US
Practice Address - Phone:334-286-2823
Practice Address - Fax:334-286-2824
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN144605363LN0000X
AL1-099175363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal