Individual provider · Type 1 NPI
Tyisha G. Potter, RN
Hospice Registered Nurse · Long Island City, NY
NPI number
1104785278
Active
Practice location
3030 43rd St
Long Island City, NY 11103-2646
Mailing address
180 Heron Ln
Bronx, NY 10473-1152
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Registered Nurse Primary | 163WH1000X | 597392 (NY) |
Hospice Registered Nurse: Definition to come...
About NPI 1104785278
Tyisha G. Potter, RN's National Provider Identifier is 1104785278, issued on Jan 15, 2026. The primary taxonomy on file is Hospice Registered Nurse (163WH1000X), and the practice location is in Long Island City, NY. The record was last updated on Jan 15, 2026.