Provider Demographics
NPI:1881486280
Name:POTTS, REBECCA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:POTTS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:SPLEAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2717 N GRANDVIEW BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1672
Mailing Address - Country:US
Mailing Address - Phone:262-513-0700
Mailing Address - Fax:
Practice Address - Street 1:2717 N GRANDVIEW BLVD STE 102
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1672
Practice Address - Country:US
Practice Address - Phone:262-513-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16900-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health