Individual
JENNETTE WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
348 N BLUFF ST # 202, ST GEORGE, UT 84770-4832
(435) 772-5370
Mailing address
3770 CARRIBBEAN CIRCLE, ST GEORGE, UT 84790
(435) 772-5370
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1891478900
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891478900
—
UT
Enumeration date
07/26/2016
Last updated
07/26/2016
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