KAILEY LYNN POTRATZ


Address: 3000 32nd Ave S, Fargo, ND 58103-6132
Phone: 7013648000

KAILEY LYNN POTRATZ (NPI# 1518451434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518451434
Entity Type Individual
Full Name KAILEY LYNN POTRATZ
Credential PA-C
Practice Address 3000 32nd Ave S
Fargo
ND 58103-6132
Mailing Address Po Box 2168
Fargo
ND 58107-2168
Practice Telephone 7013648000
Practice Fax Number 7013648078
Mailing Telephone 7012345673
Mailing Fax Number 7012347195
Enumeration Date 2018-06-15
Last Update Date 2020-05-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PAC0725 ND Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2801 University Dr S, Fargo, ND 58103 7012345673 7012347195

Office Location

Street Address 3000 32ND AVE S
City FARGO
State ND
Zip Code 58103-6132

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073506648 Randy K Metcalf Thoracic Surgery (Cardiothoracic Vascular Surgery) 3000 32nd Ave S, Fargo, ND 58103-6132 2005-08-29
1861006504 Hallie M Tiffany Nurse Practitioner 3000 32nd Ave S, Fargo, ND 58103-6132 2020-09-01
1144846452 Andrea Patrice Solberg Nurse Practitioner 3000 32nd Ave S, Fargo, ND 58103-6132 2020-06-23
1669098976 Nathaniel James Piersol Nurse Anesthetist, Certified Registered 3000 32nd Ave S, Fargo, ND 58103-6132 2020-06-23
1710503545 Emily Olivia Miranda Nurse Practitioner 3000 32nd Ave S, Fargo, ND 58103-6132 2020-06-17
1619500642 Collin Docter Physical Therapist 3000 32nd Ave S, Fargo, ND 58103-6132 2020-02-18
1386276863 Corey David Bos Nurse Anesthetist, Certified Registered 3000 32nd Ave S, Fargo, ND 58103-6132 2020-02-12
1619508587 Stephanie Lee Piirainen Student in an Organized Health Care Education/Training Program 3000 32nd Ave S, Fargo, ND 58103-6132 2020-01-30
1386274918 Melissa Ann Knopik Nurse Practitioner 3000 32nd Ave S, Fargo, ND 58103-6132 2020-01-23
1205475126 Jerika A Decker Physician Assistant 3000 32nd Ave S, Fargo, ND 58103-6132 2019-12-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659924843 Amanda Hericks Dentist 1338 Gateway Drive S, Fargo, ND 58103 2019-07-17
1285298240 Ann Louise Breen Optometrist Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 2019-04-25
1245706597 Lisa Elaine Livingston Counselor 1337 14 and Half St. S., Fargo, ND 58103 2018-10-15
1528569662 Misty Lynn Hagen Counselor 901 28th St. South, Suite B, Fargo, ND 58103 2018-02-23
1083133011 Faith Homecare Professionals LLC Home Health 304 25th St S, Suite B, Fargo, ND 58103 2017-09-11
1982138749 Matthew Troyer Pharmacist 2425 13th Ave, Fargo, ND 58103 2017-04-18
1801338504 Amy Nguyen Christianson Chiropractor 1650 45th St S Ste 113, Fargo, ND 58103 2016-11-11
1245772359 Andrea Marie Hanson Nurse Practitioner 2400 32nd Ave South, Fargo, ND 58103 2016-11-07
1831647940 Abigail Carmen Burkett Vetter Nurse Practitioner 2928 University Dr S Suite 101, Fargo, ND 58103 2016-09-18
1013361302 Nancy Knowlton Speech-Language Pathologist 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 2016-04-22
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033665310 Caitlyn R Cameron Physician Assistant 4110 51st Ave South, Fargo, ND 58104 2016-08-28
1295069664 Megan Jean Boose Physician Assistant 3173 43rd St S Ste A, Fargo, ND 58104-4564 2009-10-01
1487715405 Nancy M Eastman Physician Assistant 4622 40th Ave S, Fargo, ND 58104-4394 2006-12-13
1700826369 Jeanne Waalen Physician Assistant 4200 Woodhaven St Sw, Fargo, ND 58104-3946 2006-06-08
1982642773 Linda K Regan Physician Assistant 1800 21st Avenue South, Fargo, ND 58103 2006-06-03
1437153905 Jay R Metzger Physician Assistant 306 4th St N, Fargo, ND 58102-4820 2005-06-13
1538786728 Peter V Tronset Physician Assistant 5225 23rd Ave S, Fargo, ND 58104-7927 2020-07-03
1750908455 Jordan Ann Wiedmann Physician Assistant 3201 33rd St S, Fargo, ND 58104-8823 2020-06-29
1144842089 Matthew Hockert Physician Assistant 700 1st Ave S, Fargo, ND 58103-1802 2020-05-14
1770110777 Steffani Nicole Johnston Mack Physician Assistant 700 1st Ave S, Fargo, ND 58103-1802 2020-03-27
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Competitor

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City FARGO
Zip Code 58103

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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