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Individual

SHELLEY A. WATTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN FNP-C

Contact information

Practice address
5721 W 119TH ST, OVERLAND PARK, KS 66209-3722
(913) 498-8787
(913) 498-1744
Mailing address
13725 METCALF AVE # 403, OVERLAND PARK, KS 66223-7899
(913) 498-8787
(913) 498-1744

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2000163262
MO
363L00000X
Nurse Practitioner
53-74929-072
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200549940B
KS
01
53-74929-072
KANSAS LICENSE
KS
Enumeration date
03/20/2008
Last updated
06/18/2024
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