Individual
MS. JOHNNA RAE WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
317 MAIN STREET, EAGLE BUTTE, SD 57625-1012
(605) 964-3007
(604) 964-2810
Mailing address
PO BOX 1012, EAGLE BUTTE, SD 57625-1012
(605) 964-3007
(604) 964-2810
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R028665
SD
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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