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Individual

JOHN DOUGLAS WATHEN

Active
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Individual

JOHN DOUGLAS WATHEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, BSN, MSN, PMHNP

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
28209048A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71010207A
IN

Other

Enumeration date
06/14/2020
Last updated
10/02/2020
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