Provider Demographics
NPI:1568634491
Name:POTTS, ERIKA SMITH (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:SMITH
Last Name:POTTS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:DONN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:912 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4154
Mailing Address - Country:US
Mailing Address - Phone:575-935-9000
Mailing Address - Fax:575-935-1002
Practice Address - Street 1:912 W 21ST ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4154
Practice Address - Country:US
Practice Address - Phone:575-935-9000
Practice Address - Fax:575-935-1002
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR54735363LF0000X
NMCNP01318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM30528551Medicaid