Parks, Kelly Potter

Parks, Kelly Potter is an individual health care provider with primary practice located at 121 S Front St , Seaford DE 19973-3511. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Parks, Kelly Potter can be contacted via phone (302) 629-5030.

Contact Information

Primary practice address
121 S Front St Seaford DE 19973-3511
Phone: (302) 629-5030
Fax: (302) 629-5035
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X C5-0000165 Delaware

Profile Details

NPI number 1184746026
LBN Legal business name Parks, Kelly Potter
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2007
Last updated Aug 16th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184746026 NPPES
Delaware Other C5-0000165 STATE LICENSE NUMBER
Delaware Other RXPA02015 STATE LICENSE NUMBER

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