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Individual
MARY A. WATTS
Active
Individual
MARY A. WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., CNS, FNP, OCN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
501506
TX
364S00000X
Clinical Nurse Specialist
501506
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154419901
—
TX
01
—
890001189
RR MEDICARE
TX
01
—
8N2987
BCBS
TX
Enumeration date
11/20/2006
Last updated
10/28/2010
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