Provider Demographics
NPI:1053175281
Name:POTTS, KA'BRESHA RHETTA (RN)
Entity type:Individual
Prefix:
First Name:KA'BRESHA
Middle Name:RHETTA
Last Name:POTTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5814 SPELLMAN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-6043
Mailing Address - Country:US
Mailing Address - Phone:228-346-8363
Mailing Address - Fax:
Practice Address - Street 1:5814 SPELLMAN RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-6043
Practice Address - Country:US
Practice Address - Phone:228-346-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140760163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse