Individual
MR. JENNIFER L WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
179 BLACKSTONE CIR, BRANDON, MS 39047-8808
(601) 341-0455
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R865910
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02978845
—
MS
Enumeration date
05/08/2006
Last updated
03/06/2014
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