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Individual

MR. JOHN WILLIAM WATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
400 SAND ISLAND RD, USCG MEDICAL CLINIC, HONOLULU, HI 96819
(808) 842-2930
Mailing address
95-208 WAIKALANI DR, MILILANI, HI 96789-3545
(808) 623-6950
(808) 842-2956

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN 63
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20850-4
HI
01
APRN 63
STATE APRN LICENSE
HI
01
RN-27892
RN LICENSE
HI
Enumeration date
12/20/2006
Last updated
07/09/2007
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