Provider Demographics
NPI:1285061937
Name:POTTERFIELD, DENISE LEA
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LEA
Last Name:POTTERFIELD
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 1:401 S 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-2202
Mailing Address - Country:US
Mailing Address - Phone:515-468-4042
Mailing Address - Fax:
Practice Address - Street 1:401 S 8TH AVE
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-2202
Practice Address - Country:US
Practice Address - Phone:515-468-4042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator