Individual
CHRISTY WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,RN,FNP-C
Contact information
Practice address
210 COLLEGE ST, MCDONOUGH, GA 30253-3300
(470) 878-6401
Mailing address
1757 ROCK QUARRY RD STE A, STOCKBRIDGE, GA 30281-7303
(770) 474-7151
(770) 474-7151
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN170782
GA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
RN170782
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003205587A
—
GA
01
—
14319453
CAQH
—
Enumeration date
08/08/2016
Last updated
05/16/2019
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