Mrs Sparkle Mahogany Potter, CRNA | |
77 Nealy Ave, Langley Afb, VA 23665-2040 | |
(757) 764-6015 | |
Not Available |
Full Name | Mrs Sparkle Mahogany Potter |
---|---|
Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 77 Nealy Ave, Langley Afb, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033508213 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 0024182190 (Virginia) | Primary |
Entity Name | Virginia Anesthesia And Perioperative Care Specialists Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760417281 PECOS PAC ID: 2062419377 Enrollment ID: O20061030000565 |
Entity Name | Smg Anesthesia Specialists Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518205004 PECOS PAC ID: 6305081118 Enrollment ID: O20130327000494 |
Mailing Address | Practice Location Address |
---|---|
Mrs Sparkle Mahogany Potter, CRNA 77 Nealy Ave, Langley Afb, VA 23665-2040 Ph: (757) 764-6015 | Mrs Sparkle Mahogany Potter, CRNA 77 Nealy Ave, Langley Afb, VA 23665-2040 Ph: (757) 764-6015 |
Mr. Danny Coleman Sandefur, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 77 Nealy Ave, Langley Afb, VA 23665 Phone: 702-236-2862 | |
Mr. Darwin Michael Brooks, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 77 Nealy Ave, Langley Afb, VA 23665 Phone: 757-764-6366 |