Individual
MELISSA ANN WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CRNA
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(570) 574-1992
Mailing address
7751 COUGHRAN RD, PLEASANTON, TX 78064-4435
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
215605
NC
163W00000X
Registered Nurse
26NR12899400
NJ
163W00000X
Registered Nurse
624304
NY
163W00000X
Registered Nurse
825970
TX
163W00000X
Registered Nurse
R179446
MD
163W00000X
Registered Nurse
RN564419
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
825970
TX
367500000X
Certified Registered Nurse Anesthetist
AP125194
TX
Other
Enumeration date
11/04/2013
Last updated
10/03/2024
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